超声乳化白内障吸除联合房角分离术治疗原发性闭角型青光眼合并白内障的疗效观察

目的:探讨超声乳化白内障吸除联合房角分离术治疗原发性闭角型青光眼合并白内障的疗效.方法:选择30例原发性闭角型青光眼合并白内障病人(46眼),根据术前房角粘连关闭的范围不同分为3组,其中A组17眼,术前房角粘连关闭<180°,采用超声乳化白内障吸除人工晶状体植入术进行治疗;B组16眼,术前房角粘连关闭180°~270°,采用超声乳化白内障吸除人工晶状体植入联合房角分离术进行治疗;C组13眼,术前房角粘连关闭>270°,采用超声乳化白内障吸除人工晶状体植入联合房角分离术进行治疗.比较3组病人的治疗效果.结果:治疗结束后,A组中全部无需用降眼压药物,B组需药物干预者1眼,C组需药物干预者10眼,A组和B组病人需要用降眼压药物干预率均明显低于C组(P<0.01).结论:超声乳化白内障吸除人工晶状体植入术对术前房角粘连关闭<180°病人治疗效果最好,对于术前房角粘连关闭180°~270°的病人需要联合房角分离术进行治疗才能达到较好的效果,当其角度>270°时,临床效果欠佳.

Clinical observation of phacoemulsification combined with real angular separation surgery in the treatment of primary angle closure glaucoma with cataract

Objective:To explore curative effect of the phacoemulsification combined with real angular separation surgery to treatprimary angle closure glaucoma with cataract.Methods:Thirty patients with primary closed-angle glaucoma and cataract (46 eyes) were selected randomly.According to the operation of anterior chamber angle conglutination close range,all patients were divided into 3 groups.Of them,group A include 17 eyes with anterior chamber angle synechiae closure<180°,which received phacoemulsification and intraocular lens implantation for treatment;group B include 16 eyes with anterior chamber angle synechiae closure 180°-270°,which received phacoemulsification of step-down avoidance gettering intraocular lens implantation combined with real angle separation surgery treatment;group C include 13 eyes with anterior chamber angle synechiae closure>270°,which received phacoemulsification and intraocular lens implantation combined with real angle separation surgery treatment.The curative effects of three groups were compared.Results:After the treatment,no patient in group A needed drug intervention.One eye in group B needed drug intervention.10 eyes in group C needed drug intervention.When compared with group C,There was a significant difference in drug intervention need in group A(P<0.01)or group B(P<0.01).Conclusions:There is a best curative effect for phacoemulsification cataract intraocular lens implantation surgery in treatment of the anterior chamber angle synechiae closure <180° patients.However,for the patients with anterior chamber angle closure 180°-270°,the combination of phacoemulsification cataract intraocular lens implantation surgery and corner separation surgery will be better.No good results came for the patients with anterior chamber angle closure >270° of patients need to be treated with.