不同手术方法治疗合并白内障的急性原发性房角关闭及原发性闭角型青光眼的临床效果比较

目的比较不同手术方法治疗合并白内障的急性原发性房角关闭（APAC）及原发性闭角型青光眼（PACG）的临床效果。方法回顾性分析APAC及PACG患者的I临床资料。其中30例患者采用小梁切除术治疗，共34眼。35例患者38眼PAC接受超声乳化白内障吸除术联合小梁切除术治疗。22例患者24眼接受超声乳化白内障吸除术治疗。比较三组的手术成功率、术后不同时间点眼压、手术前后视力变化等。结果超声乳化组治疗APCA的临床疗效显著优于PACG。PACG的临床疗效三组之间有差异（P〈0．05），小梁切除组和联合组的完全成功率均显著高于超声乳化组（P〈0．05）。结论小梁切除术、超声乳化白内障吸除术联合小梁切除术、单纯白内障超声乳化吸除术治疗APAC和PACG，具有不同的特征，在选择手术方式时应根据患者的具体情况、PAC的类型、手术的特征等综合考虑。

Clinical efficacy of different operations for primary angle closure with cataract

Objective To discuss clinical efficacy of different operations for primary angle closure with cataract. Methods Retrospective analyzed clinical data of patients with APAC and PACG. Thirty cases treated by trabeculecto- my. Thirty-five cases treated by trabeculectomy combined with phacoemulsification. 22 cases treated by phacoemulsi- fication. Achievement ratio of operation, intraocular pressure,changes in vision were compared. Results Clinical efficacy of phacoemulsification for APCA was better than for PACG. Clinical efficacy of three group for APCA had significant difference （P 〈 0.05）. Clinical efficacy of trabeculectomy group and combined group were better than phacoemulsifi- cation group （P 〈 0.05）. Conclusion Trabeculectomy, trabeculectomy combined with phacoemulsification and pha- coemulsification for APAC and PACG show different clinical features. When choosing operation mode should be ac- cording to the actual circumstances of the patients with PAC type operation characteristics of comprehensive considera- tion.