方法：患者43例50眼，其中原发性闭角型青光眼患者(A组)23例26眼，原发性开角型青光眼患者(B组)20例24眼，均为青光眼滤过术后6mo以上的白内障患者； 术前行视力、眼压、裂隙灯、前房角镜及角膜内皮细胞计数等检查。予行透明角膜切口白内障超声乳化联合人工晶状体植入手术，术后随访3～12mo，观察记录视力、眼压、角膜内皮细胞计数及视野等。

结果：患者50眼(100%)术后视力均有不同程度提高，41眼(82%)术后视力≥0.3； 术前平均眼压，A组18.08±5.08mmHg(1mmHg=0.133kPa)，B组14.48±3.52mmHg； 术后随访平均眼压，A组13.65±3.51mmHg，B组14.28±3.41mmHg，A组手术前后眼压变化明显(P<0.05)； B组手术前后眼压变化均无统计学差异(P<0.05)； A组1眼和B组3眼术后3d内眼压升高，眼压波动在21～33mmHg，经药物治疗恢复正常并停药； 随访过程中眼压稳定。角膜内皮细胞密度：术前A组 2 293.57±352.24cells/mm²，B组2 658.14±458.69cells/mm²，术后A组2 175.95±379.16 cells/mm²，B组2 442.97±477.30cells/mm²； 细胞丢失率：A组5.13%，B组8.10%； 术后视力恢复时间与患者视野损害程度有关，视野损害严重者视力恢复时间长。

结论：透明角膜切口白内障超声乳化术治疗青光眼滤过手术后白内障视功能恢复稳定，眼压能有效控制，并能进一步降低闭角型青光眼的眼压。术前对患眼全面评价及适当的手术技巧有助于手术效果的提高且减少并发症的发生。

METHODS: Totally 43 cases(50 eyes), in which 23 patients with primary angle-closure glaucoma(group A, 26 eyes)and 20 patients with primary open angle glaucoma(group B, 24 eyes), all had undergone glaucoma filtration surgery for more than 6 months. Visual acuity, intraocular pressure, slit lamp, gonioscope, corneal endothelial cell counts, etc., were done before surgery.And transparent corneal incision phacoemulsification combined with artificial lens implantation operation were preformed, postoperative follow-up of 3 to 12 months, visual acuity, intraocular pressure, corneal endothelial cell counts and vision field, etc. were observed and recorded.

RESULTS: The visual acuity of 50 eyes(100%)increased with different degree postoperatively, 41 eyes(82%)with postoperative visual acuity ≥0.3; average preoperative intraocular pressure: group A 18.08±5.08mmHg(1mmHg=0.133kpa), group B 14.48±3.52mmHg; Postoperative follow-up average intraocular pressure: group A 13.65±3.51mmHg, group B 14.28±3.41 mmHg, intraocular pressure changed significantly pre and post-operation in group A(P<0.05), there was no significant difference between pre and post-operation in group B(P>0.05); Postoperative intraocular pressure of 1 eye in group A and 3 eyes in group B rose within three days post-operation, the intraocular pressure fluctuated between 21-33mmHg, with drug therapy and drug withdral when intraocular pressure epistrophy; Intraocular pressure was stable in the follow-up process.Corneal endothelial cell density: pre-operation group A was 2 293.57±352.24(cells/mm²), group B 2 658.14±458.69(cells/mm²), post- operation group A 2 175.95±379.16(cells/mm²), group B 2 442.97±477.30(cells/mm²), cell loss rate: 5.13% in group A, and 8.10% in group B. Postoperative visual acuity was related to vision field damage in patients, the more visual field damage, the longer the duration.

CONCLUSION: Visual function restore is stable in transparent corneal incision phacoemulsification in cataract patients who underwent glaucoma filtration surgeries; the intraocular pressure can be controlled effectively, and can further reduce the intraocular pressure of angle-closure glaucoma. Preoperative comprehensive evaluation of the affected eye and appropriate technique selection are benefit to the improvement of operation effect and the reduction of complications.