| 超声乳化联合小梁切除术或房角分离术治疗合并白内障的慢性原发性闭角型青光眼 |
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| 引用本文： | 苟文军,杨旭,方晏红,刘灵琳,龙波,刘思源.超声乳化联合小梁切除术或房角分离术治疗合并白内障的慢性原发性闭角型青光眼[J].眼科新进展,2015,0(9):884-886. |
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| 作者姓名： | 苟文军 杨旭 方晏红 刘灵琳 龙波 刘思源 |
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| 作者单位： | 629000 四川省遂宁市，遂宁市中心医院眼科 |
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| 摘 要： | 目的 对比观察白内障超声乳化联合小梁切除术与白内障超声乳化联合房角分离术治疗合并白内障的慢性原发性闭角型青光眼的临床疗效。方法 选择合并白内障的慢性原发性闭角型青光眼患者１００例１００眼分为２组，Ａ组５０例５０眼施行白内障超声乳化吸出加人工晶状体植入联合小梁切除术，Ｂ组５０例５０眼施行白内障超声乳化吸出加人工晶状体植入联合房角分离术。术后随访１２个月，记录并比较患者术前及术后１２个月的最佳矫正视力、眼压、前房深度及并发症情况。结果 Ａ组、Ｂ组术后１２个月的最佳矫正视力分别为０．７０±０．１７和０．６９±０．１４，均较术前的０．２７±０．０２和０．２６±０．０４明显提高，差异均有统计学意义（均为Ｐ＜０．０１）。Ａ组、Ｂ组术后１２个月的眼压分别为（１４．９３±２．９７）ｍｍＨｇ（１ｋＰａ＝７．５ｍｍＨｇ）和（１４．８２±３．０１）ｍｍＨｇ，均较术前的（３６．６２±３．３０）ｍｍＨｇ和（３７．１８±２．９６）ｍｍＨｇ明显降低，差异均有统计学意义（均为Ｐ＜０．０１）；但Ｂ组有２７眼眼压高于２１ｍｍＨｇ，需加用１～２种降眼压药物才能将眼压控制在正常范围。Ａ组、Ｂ组术后１２个月的前房深度分别为（４．５６±０．０４）ｍｍ和（４．６０±０．０７）ｍｍ，均较术前的（１．４６±０．２５）ｍｍ和（１．４４±０．２７）ｍｍ明显加深，差异均有统计学意义（均为Ｐ＜０．０１）。Ａ组、Ｂ组术后１２个月最佳矫正视力、眼压及前房深度的比较差异均无统计学意义（均为Ｐ＞０．０５）。Ａ组术后１３眼出现浅前房，１眼前房少许出血，３眼发生恶性青光眼；Ｂ组术后未见浅前房等并发症发生。结论 白内障超声乳化联合小梁切除术与白内障超声乳化联合房角分离术均能有效控制慢性原发性闭角型青光眼患者眼压、提高视力。
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| 关 键 词： | 白内障超声乳化 小梁切除术 房角分离术 慢性原发性闭角型青光眼 |
Phacoemulsification with trabeculectomy or goniosyn-echialysis for chronic primary angle-closure glaucoma with cataract |
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| GOU Wen-Jun,YANG Xu,FANG Yan-Hong,LIU Ling-Lin,LONG Bo,LIU Si-Yuan. Phacoemulsification with trabeculectomy or goniosyn-echialysis for chronic primary angle-closure glaucoma with cataract[J].Recent Advances in Ophthalmology,2015,0(9):884-886. |
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| Authors: | GOU Wen-Jun YANG Xu FANG Yan-Hong LIU Ling-Lin LONG Bo LIU Si-Yuan |
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| Affiliation: | Department of Ophthalmology , Suining Central Hospital , Sui-ning 629000 , Sichuan Province . China |
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| Abstract: | Objective To observe the clinical efficacy of phacoemulsification with trabeculectomy or goniosynechialysis for chronic primary angle-closure glaucoma with cataract. Methods One hundred eyes of 100 chronic primary angle-closure glaucoma with cataract patients were divided into two groups randomly , group A underwent phacoemulsification with trabeculectomy, group B underwent phacoemulsification with goniosynechialysis ,50 cases ( 50 eyes) in each group. All patients were followed-up for 12 months. The best corrected visual acuity, intraocular pressure. anterior chamber depth and complication were recorded and compared between pre-operation and post-operative 12 months. Results The best corrected visual acuity at postoperative 12 months in ~oup A and group B were 0. 70 +0. 17 and 0. 69 +0. 14 ,respectively, were significantly higher than preoperative 0. 27 +0. 02 and 0. 26 + 0. 04 ( all P < 0. 01 ). The intraocular pressure at postoperative 12 months in group A and group B were ( 14. 93 +2. 97 ) mmHg ( I kPa = 7. 5 mmHg) and ( 14. 82 + 3. 01 ) mmHg ,respectively , were significantly lower than preoperative ( 36. 62 + 3. 30) mmHg and ( 37. 18 + 2. 96 ) mmHg ( all P < 0. 01 ) . But the intraocular pressure in 27 eyes was greater than 21 mmHg , and needed to add I t0 2 kinds of antihypertensive drugs in order to control the intraocular pressure in the normal range. The anterior chamber depth at postoperative 12 months in group A and group B were (4. 56 + 0. 04 ) mm and ( 4. 60 + 0. 07 ) mm, respectively, were si~ificantly deeper than preoperative ( 1. 46 + 0. 25 ) mm and (1. 44 +0. 27 ) mm ( all P < 0. 01 ) . The difference in best corrected visual acuity , intraocular pressure and anterior chamber depth was not statistical significant between group A and group B ( all P > 0. 05) . In group A,the shallow anterior chamber appeared in 13 eyes ,few hyphema in I eye , and malignant glaucoma in 3 eyes;No above complication appeared in group B. Conclusion Both phacoemulsification with trabeculectomy and phacoemulsification with goniosynechialysis for chronic primary angle-closure glaucoma with cataract can effectively control the intraocular pressure and improve the visual acuity. |
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| Keywords: | Phacoemulsification trabeculectomy goniosynechialysis chronic primary angle-closure glaucoma |
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