不同联合手术方式对白内障合并闭角型青光眼的疗效分析

目的: 观察超声乳化白内障摘除人工晶状体植入术联合小梁切除术,超声乳化白内障摘除人工晶状体植入术联合房角分离术治疗白内障合并闭角型青光眼的临床疗效,为治疗白内障合并闭角型青光眼提供可靠方法。方法: 收集白内障合并闭角型青光眼患者78例106眼,将其随机分为两组:其中A组患者40例56眼,采用超声乳化白内障摘除人工晶状体植入术联合小梁切除术治疗;B组患者38例50眼,采用超声乳化白内障摘除人工晶状体植入术联合房角分离术治疗,对其疗效进行对比分析,观察治疗前后视力、眼压、前房深度、房角的变化及并发症的发生率。结果: 两组手术顺利,视力、眼压、前房深度、房角变化在手术前后具有显著的差异(P<0.05)。两组手术后疗效的比较,房角镜检查:A组56眼房角完全开放的49眼;B组50眼房角360°开放的44眼,两组间无统计学差异。术前前房深度:A组为1.73±0.42mm,B组为1.78±0.39mm;术后前房深度:A组为3.25±0.36mm,B组为2.91±0.53mm,两组间有统计学差异(P<0.05)。A组并发症发生率明显高于B组。结论: 超声乳化白内障摘除人工晶状体植入术联合房角分离术治疗白内障合并闭角型青光眼可明显地提高视力,有效地控制眼压,减少手术早期并发症,且操作简便,可广泛运用。

Clinical analysis of the treatment effect for cataract and angle-closure glaucoma with different joint operations

AIM: To compare the clinical effect of phacoemulsification cataract extraction and intraocular lens implantation combined with trabeculectomy, and goniosynechialysis in the treatment of cataract and angle-closure glaucoma. The results provided a reliable method for the treatment of cataract patients with angle-closure glaucoma.

METHODS: Seventy-eight patients(106 eyes)with cataract and angle-closure glaucoma were randomly divided into two groups. Group A contained 40 patients(56 eyes)which were treated by using phacoemulsification cataract extraction and intraocular lens implantation combined with trabeculectomy. Group B included 38 patients(50 eyes)which were treated with phacoemulsification cataract extraction and intraocular lens implantation combined with goniosynechialysis. The clinical effect was compared between the two groups. The following clinical parameters were tested before and after treatment: visual acuity, intraocular pressure, anterior chamber depth, and incidence of complications.

RESULTS: The operations of the two groups were all smooth. There was significant difference between before and after treatment concerning visual acuity, intraocular pressure, anterior chamber depth, angle changes(P<0.05). Comparison of the efficacy of the two groups after operations: 49 eyes angle completely open in group A, 44 eyes angle completely open in group B. No significant statistical difference was found between the two groups. Preoperative anterior chamber depth: group A was 1.73±0.42mm and group B was 1.78±0.39mm; anterior chamber depth after operation: group A was 3.25±0.36mm, group B was 2.91±0.53mm. There was significant difference between the two groups. Occurrence of complications in group A was significantly higher than that of group B.

CONCLUSION: Phacoemulsification cataract extraction and intraocular lens implantation combined with goniosynechialysis in the treatment of cataract patients with angle-closure glaucoma can significantly improve visual acuity, effectively control intraocular pressure, and reduce early complications of operation. The method of operation is simple, and can be widely used.