双切口行白内障超声乳化联合小梁切除术的临床应用

目的通过双切口行白内障超声乳化联合小梁切除术治疗青光眼和白内障,观察患者手术前后视力、眼压改变及术后并发症情况。方法选取我院自2010年1月至2013年12月青光眼合并白内障患者60例(78眼),将双切口行白内障超声乳化联合小梁切除病例32例(40眼)作为观察组,另外28例(38眼)行白内障超声乳化手术作为对照组,观察2组患者手术前后视力、眼压及前房情况,并随访3~6个月。结果 2组患者手术后视力均有明显提高,眼压有明显改善,但观察组更显著,P0.05,差异有统计学意义。观察组患者前房出现不同的炎症反应,有2例发生前房渗出,对照组前房炎症反应稍轻;2组患者无前房出血、浅前房、脉络膜脱离等发生。结论采用双切口行青光眼白内障联合手术后视力恢复好,眼压控制满意;虽然术后前房反应稍重,但用药后很快缓解,减少了患者多次手术的痛苦及经济负担,但要严格选择病例。

Clinical application of double incision in phacoemulsification combined with trabeculectomy

Objective Conducting phacoemulsification combined with trabeculectomy through double incision to treat glaucoma and cat- aract,and observing the visual acuity,intraocuiar pressure before and after the operation and complications of this therapy. Methods Totally 60 patients （78 eyes） with glaucoma and cataract from January 2010 to December 2013 in our hospital were observed. 32 patients （40 eyes） who were given phacoemulsification combined with trabeculectomy through double incision were regarded as the observation group, and the other 28 patients （38 eyes） who were merely given phacoemulsification were regarded as the control group. The visual acuity, intraocular pres- sure and anterior chamber of the two groups were observed and recorded, and they were followed up for 3 - 6 months. Results Visual acuity and intraocular pressure of the two groups were improved after operation, but the observation group achieved a better result which showed a significant difference （P 〈 0.05 ）. Anterior chamber inflammation occurred in patients of the observation group, and 2 cases were of anterior chamber exudation. The control group, by contrast, has less anterior chamber inflammation. There was no hyphema, shallow anterior chamber, choroidal detachment occurred in both of the two groups. Conclusion Using phacoemulsification combined with trabeculectomy through double incision to treat glaucoma and cataract could receive a good recovery of visual acuity and intraocular pressure. Although, more severe anterior chamber inflammation occurred after operation compared with the control group, it can be alleviated soon after medication. This meth- od is a good therapy which can reduce pain and economic burden of patients from multiple operations. But it requires a strict selection of ap- propnate case.