房角分离术辅助治疗合并白内障的闭角型青光眼的疗效

目的：探讨超声乳化白内障摘除辅助房角分离术治疗合并白内障的闭角型青光眼的临床效果。方法：连续选择2012－02／2014－02收入我院诊断为合并白内障的闭角型青光眼患者共68例，根据简单数字法将患者随机分为试验组和对照组，每组34例。对照组患者给予常规手术，试验组患者给予超声乳化白内障摘除辅助房角分离术，对比两组患者的术后效果及并发症差异性。结果：两组患者术前的视力水平和眼压的比较，差异均无统计学意义（ P＞0．05）；术后两组患者的视力水平均提高，眼压均下降，且试验组改善的更明显，差异均有统计学意义（P＜0．05）。两组患者术前中央前房深度和房角宽度的比较，差异均无统计学意义（P＞0．05）；术后两组患者的中央前房深度和房角宽度均上升，且试验组改善的更明显，差异均有统计学意义（P＜0．05）。试验组患者的手术并发症（包括角膜水肿、浅前房、虹膜纤维素样渗出、结膜滤过泡渗漏和后发性白内障）的发生率显著低于对照组，差异有统计学意义（P＜0．05）。结论：房角分离术辅助治疗合并白内障的闭角型青光眼效果显著，并发症少，安全性高，值得临床推广。

Clinical analysis of goniosynechialysis assisting the treatment of angle closure glaucoma with cataract

AIM: To study the clinical effect of goniosynechialysis assisting the treatment of angle closure glaucoma with cataract.

METHODS: A total of 68 consecutive patients diagnosed as angle closure glaucoma combined with cataract from February 2012 to February 2014 were divided randomly into experiment and control groups, each with 34 cases. The patients in control group received glaucoma-cataract combined operation, and the patients in experiment group received phacoemulsification assisted by goniosynechialysis. Then the clinical effect and complications of the two groups were compared.

RESULTS: The visual acuity and intraocular pressure(IOP)before treatments in the two groups were not statistically different(P>0.05). The visual acuity was higher and IOP were lower in the two groups after treatments and in experiment group they were more significantly improved than those of control group(P<0.05). The central anterior chamber depth and chamber angle width before treatments in the two groups were not statistically different(P>0.05). They were both higher in the two groups after treatments and in experiment group they were more significantly improved than those of control group(P<0.05). The complications, including corneal swelling, shallow anterior chamber, iris fibrous exudation, conjunctival bleb leakage and secondary cataract in experiment group was significantly less(P<0.05).

CONCLUSION: The goniosynechialysis assisting the treatment of angle closure glaucoma with cataract is effective, safe with less complication, which deserves promotion.