超声乳化联合小梁切除术治疗急性闭角型青光眼合并年龄相关性白内障的疗效分析

目的　评估超声乳化人工晶状体植入联合小梁切除术治疗急性闭角型青光眼合并年龄相关性白内障的疗效。方法　回顾性分析２０１２年１月至２０１３年１２月于我院住院治疗的急性闭角型青光眼合并年龄相关性白内障患者５４例（５６眼）的临床资料，根据手术方式不同分为２组，Ａ组行超声乳化人工晶状体植入联合小梁切除术，Ｂ组行超声乳化吸出人工晶状体植入术，分析两组术前及术后２个月视力、眼压、前房深度、前房角宽度改善情况及并发症情况等。结果　２组术后视力较术前均不同程度提高，差异均有统计学意义（均为Ｐ＜０．０５）；２组患者术后视力组间比较，差异无统计学意义（χ２＝０．１３２，Ｐ＝０．７１６）。２组术前眼压分别为（２３．１５±２．４７）ｍｍＨｇ（１ｋＰａ＝７．５ｍｍＨｇ）、（２３．９４±３．０７）ｍｍＨｇ，术后眼压分别为（１４．９５±１．８６）ｍｍＨｇ、（１３. ７２±２．４１）ｍｍＨｇ，２组术前眼压差异无统计学意义（ｔ＝１．０６１，Ｐ＝０．２９４）；２组术后眼压较术前均不同程度降低，差异均有统计学意义（均为Ｐ＜０．０５）；２组患者术后眼压组间比较，差异无统计学意义（ｔ＝１．９１０，Ｐ＝０．０６２）。２组术后前房深度及前房角宽度较术前均不同程度增加，差异均有显著统计学意义（均为Ｐ＜０．００１）；２组患者术后前房深度及前房角宽度比较，差异均无统计学意义（ｔ＝１．３００、０．９２４，Ｐ＝０．１９９、０．３５９）。两组并发症发生率差异有统计学意义（χ２＝４．３８３，Ｐ＝０．０３６）。结论　超声乳化人工晶状体植入联合小梁切除术治疗急性闭角型青光眼合并年龄相关性白内障疗效确切，并发症少，可作为优先选择的手术方式。

Clinical efficacy of phacoemulsification with trabeculectomy for acute angle-closure glaucoma with age-related cataract

Objective To assess the clinical efficacy of phacoemulsification with trabeculectomy for acute angle-closure glaucoma with age-related cataract. Methods Fifty-four patients ( 56 eyes) with acute angle-closure glaucoma and age-related cataract in our hospital from January 2012 to December 2013 were chosen , and according to the surgical methods. the patients were divided into two groups,28 eyes were performed with phacoemulsification with trabeculectomy ( group A) , when the other 28 eyes were performed with phacoemulsification plus intraocular lens implantation ( group B ) . The preoperative and postoperative visual acuity, intraocular pressure. anterior chamber depth , anterior chamber angle width and complications of patients in two groups were compared. Results The postoperative visual acuity in two groups were all increased. there were statistical differences ( all P < 0. 05 ) .while there was no statistical difference in postoperative visual acuity between two groups (X2 = 0. 132 .P = 0. 716 ) . The preoperative intraocular pressure of group A and B were ( 23. 15 +2. 47 ) mmHg ( I kPa = 7. 5 mmHg) and ( 23. 94 + 3. 07 ) mmHg , respectively , while the postoperative intraocular pressure were ( 14. 95 + 1. 86 ) mmHg and ( 13. 72 + 2. 41 ) mmHg , respectively , there was no statistical difference in preoperative intraocular pressure between two groups ( t = 1 . 061 .P = 0. 294 ) . and the differences found between the preoperative and postoperative intraocular pressure of two groups ( all P < 0. 05 ) , but no difference was found between two groups ( t = 1. 910 .P = 0. 062) . The postoperative anterior chamber depth and angle width were all increased , there were sigruficant differences ( all P < 0. 001 ) , but no difference was found between two groups ( t = 1. 300 ,0. 924 ;P = 0. 199 ,0. 359 ) . There was no statistical difference rn complication between two groups (X2 = 4. 383 , P = 0. 036 ) . Conclusion Phacoemulsification with trabeculectomy for acute angle-closure glaucoma with age-related cataract has good clinical efficacy with less complications . and can be used as the preferred choice.