35例青光眼合并白内障临床治疗分析

目的探讨白内障超声乳化人工晶体植入联合抗青光眼手术在治疗青光眼合并白内障中的疗效。方法选取原发性闭角型青光眼(primary angle-closure glaucoma，PACG)合并年龄相关性白内障，房角粘连>120°且≤270°。患者35例(45眼)，随机分为A组(超声乳化人工晶状体植入联合房角分离手术组)和B组(超声乳化人工晶状体植入联合房小梁切除手术组)，术后随访6个月，观察视力、眼压、视野等变化。结果两组术后视力和眼压均较术前显著发生变化，组间无统计学差异。两组视野基本上保持原有水平，A组几乎所有纳入者术后随访前房角均有增宽，B组60%房角增宽。A组发生并发症1人，B组发生并发症4人，B组住院平均天数较A组长。结论两种联合术式治疗PACG合并白内障均有显著疗效。但联合小梁切除术的术后并发症多于联合房角分离手术组，故优先考虑联合房角分离术。

Clinical Analysis of angle-closure glaucoma and cataract in 35 cases

Objective To analyze the effect of phacoemulsification combined anti- giaucoma surgery for cataract extraction in the treatment of angle-closure glaucoma and cataract. Methods Totally 35 cases（45 eyes） of primary angle-closure glaucoma which had age-related cataract and closed range of anterior chamber angle more than 120~ and less than or equal 270~. 35 cases（45 eyes） were randomly allocated into 2 groups： Group Aphacoemulsification surgery with intraocular lens （IOL） implantation combined goniosychialysis] and Group Bphacoemulsification surgery with intraocular lens （IOL） implantation combined trabeculectomy]. The vision, intraocular pressure（IOP）, visual field was ol：~erved in 6 mouths. Results Both groups＇ postoperative visual acuity and IOP were significantly improved, respectively, but there was no significant difference between the 2 groups. Two groups of visual field keep the original level. The anterior chamber angles became wilder in almost of patients in group A, but group B has 60% wilder. One person in group A has complicated, while 4 people in group B, and group B is averagely longer in hospital than group A. Conclusion Two kinds of joint operation have remarkable curative effect. But combined-trabeculectomy has more complications therefore, giving priority to combined- goniosychialysis.