小梁切除联合超声乳化白内障吸除术与分阶段手术的对比分析

目的:比较小梁切除联合超声乳化白内障吸除术和分阶段手术治疗青光眼合并白内障的临床疗效。方法:青光眼合并白内障患者施行小梁切除联合超声乳化白内障吸除术82例(82眼)为联合手术组,先施行小梁切除术后施行超声乳化白内障吸除术38例(38眼)为分阶段手术组。比较两组术后视力、眼压、手术并发症和角膜内皮细胞丢失率等。结果:两组术后均随访3mo以上。视力:≥0.5联合手术组56眼(68.3%),分阶段手术组30眼(78.9%);≥1.0联合手术组26眼(31.7%),分阶段手术组6眼(15.8%),两组比较差异无显著性(χ2=1.452和3.364,P>0.05)。眼压:两组术后随访平均眼压分别为(11.08±4.68)mmHg和(11.57±3.25)mmHg,两组比较差异无显著性(t=0.587,P>0.05)。手术并发症:联合手术组多于且重于分阶段手术组,但均经常规治疗后恢复正常。角膜内皮细胞丢失率:联合手术组平均为(20.06±18.03)%,分阶段手术组为(15.07±15.22)%,两组比较差异无显著性(t=0.996,P>0.05)。结论:小梁切除联合超声乳化白内障吸除术和分阶段手术均是治疗青光眼合并白内障的安全、有效方法。

A comparative study between trabeculectomy combined with phacoemulsification and glaucoma surgery by stages

·AIM:To compare the clinical effects of combined procedure versus staged procedure for treatment of glaucoma with cataract..METHODS:This retrospective clinical study included 120 patients(120 eyes)In group A,82 eyes with glaucoma and cataract underwent trabeculectomy combined with phacoemulsification and intraocular lens implantation,and in group B,38 eyes with cataract after trabeculectomy were treated by phacoemulsification and intraocular lens implantation.The best corrected visual acuity(BCVA),intraocular pressure(IOP),complications and the loss rate of corneal endothelial cells after the operation were observed and compared..RESULTS:All cases were followed up for over 3 mon-ths.The postoperative BCVA of two groups was obviously improved,and there was no significant difference between two groups(P>0.05).Besides,the mean IOP of two groups were 11.08±4.68 mmHg and 11.57±3.25 mmHg respectively,which had no significant difference(P>0.05).The complications in group A occurred more frequently and more severely than those in group B.How-ever,all patients recovered to normal through conven-tional treatment.The percentage of corneal endothelial cell loss in group A was 20.06±18.03%,and 15.07±15.22% in group B.There was no significant difference between two groups(P>0.05)..CONCLUSION:Trabeculectomy combined with phacoe-mulsification and surgeries by stages are successful,safe and effective ways of treatment for patients with glau-coma and cataract..