超声乳化联合房角分离治疗PACG合并白内障

目的:观察超声乳化吸出联合房角分离术(phacoemulsificationcombined with goniosynechialysis,Phaco-GSL)对原发性闭角型青光眼(primary angle-closure glaucoma,PACG)合并白内障患者前房及眼压的影响。方法:对36例36眼PACG合并白内障患者随机分为观察组18例和对照组18例,观察组行Phaco-GSL治疗,对照组行单纯Phaco治疗,手术前后记录前房结构、眼压与视力变化。结果:观察组患者术后房角开放>270°者为18例(100%),对照组为10例(56%),两组比较有统计学意义(P<0.01);术后前房加深观察组为1.208±0.181mm,对照组为0.883±0.074mm,两组比较有统计学意义(P<0.01);术后眼压在脱离药物治疗的情况下降至正常范围者观察组为15例(83%),对照组为9例(50%),两组比较有统计学意义(P<0.01);术后视力均有提高,但两组比较无统计学意义(P>0.05)。结论:Phaco-GSL术对PACG合并白内障患者能够明显改善前房结构,有效降眼压,达到理想的治疗作用。

Clinical observation on phacoemulsification combined with goniosynechialysis for treatment of PACG with cataract

AIM:To observe the influence of phacoemulsification combined with goniosynechialysis(Phaco-GSL) on anterior chamber and intraocular pressure(IOP) for primary angle-closure glaucoma(PACG) with cataract patients·METHODS:Totally 36 patients(36 eyes) with PACG and cataract were randomly divided into observation group of 18 patients and control group of 18 patients,the observation group underwent Phaco-GSL treatment,the control group was treated with simple Phaco surgery,changes in anterior chamber structure,IOP and visual acuity were recorded before and after the surgery·RESULTS:The patients with postoperative anterior chamber angle opening greater than 270° were 18 cases(100%) in the observation group,10 cases(56%) in the control group,the comparison between two groups was statistically significant(P <0.01);Postoperative anterior chamber deepened 1.208±0.181mm in the observation group,0.883±0.074 mm in the control group,the comparison between two groups was statistically significant(P<0.01);The patients with postoperative IOP decreased to the normal range in the case of no drug treatment were 15 cases(83%)in the observation group,9 cases(50%)in the control group,the comparison between two groups was statistically significant(P<0.01);All the postoperative visual acuity had improved,but the comparison between two groups was not statistically significant(P>0.05)·CONCLUSION:Phaco-GSL can significantly improve anterior chamber structure with effective lowering IOP to achieve the desired therapeutic effect for the patients of PACG with cataract.