小梁切除术联合超声乳化治疗原发性闭角型青光眼的效果观察

目的比较超声乳化联合小梁切除术和单纯小梁切除术在治疗原发性闭角型青光眼合并白内障中的疗效和安全性。方法31例（31只眼）原发性闭角型青光眼伴有白内障患者，其中17例（17只眼）接受小梁切除术联合超声乳化治疗，14例（14只眼）接受小梁切除术治疗。在术后随访过程中分别记录并比较两组患者眼压、滤过泡和并发症等状况。结果术后随访10个月，发现超声乳化小梁切除术组和小梁切除术组在眼内压降低值[（20．59±7．94）mmHgV8（24．85±14．39）mmHg，P=0．614）]、治愈率（88．24％VS71．43％，尸卸．370）、功能性小泡形成率[76．47％（13／17）vs78．57％（11／14），P=0．094]和并发症发生率【（47．06％（8／17）VS．50．00％（7／14），P=0．380）】方面差异无统计学意义。两组中大多数患者不能用降低眼内压的药物。在小梁切除术组需要额外的手术干预，包括对眼前房的改善和超声乳化白内障法。结论即使在小梁切除术后的白内障和并发症患者中，在某些情况下可能需要额外的手术干预，但在治疗原发性闭角型青光眼和白内障并发性患者时，超声乳化小梁切除术和小梁切除术显示出类似的眼内压降低值、成功率和并发症。

Clinical analysis of trabeculectomy combined with ultrasonic emulsification therapy for the treatment of primary angle-closure glaucoma.

Objective To compare the efficacy and safety of ultrasonic emulsification combined with trabeculectomy and simple trabeculectomy in the treatment of primary angle-closure glaucoma with cataract. Methods Thirty-one patients （31 eyes） with primary angle-closure glaucoma with cataract were randomized into two groups, of which 17 received ultrasonic emulsification combined trabeeulectomy and 14 received simple trabeculectomy. During the follow-up visit, incidence of complications, filtering bleb formation rate and intraocular pressure （IOP） were record- ed and compared between the two groups. Results During the ten-month follow up visit, we found that IOP reduction value in the ultrasonic emulsification trabeculectomy group and simple trabeculectomy group were （20.594-7.94） mmHg vs （24.85±14.39） mmHg, （P=0.614）. The cure rates were 88.24% vs 71.43% （P=0.370）, filtering bleb formation rates were 76.47% （13/17） vs 78.57% （11/14）, P=0.094, and incidences of complications were 47.06% （8/17） vs 50.00% （7/14）, P=0.380. No significant differences were observed. Most of the patients in two groups had no need to use drugs to reduce IOE Additional surgical interventions were needed in the trabeculectomy group, including the strategy of eliminating the anterior chamber to improve the method of ultrasonic emulsification and phacoemulsfication. Conclusion Even if in some cases additional surgical interventions are needed for PACG patients with cataract after simple trabeculectomy therapy, the ultrasonic emulsification combined trabeculectomy and simple trabeculectomy show similar IOP reduction values, success rates and complication incidences.