白内障摘出联合睫状体光凝或小梁切除术治疗原发性闭角型青光眼效果及对眼表的影响

目的 比较晶状体超声乳化术联合睫状体光凝术(CPC)或晶状体超声乳化术联合小梁切除术(CPT)治疗原发性闭角型青光眼(PACG)的效果及对眼表的影响.方法 纳入合并白内障行手术治疗的PACG患者101例(101眼),并根据接受手术方式的不同分为两组:CPC组患者接受CPC,共46例(46眼);CPT组接受CPT,共55...

Comparison of curative effect and ocular surface changes after cyclophotocoagulation or trabeculectomy combined with cataract surgery for primary angle closure glaucoma

Objective　To compare the anti-glaucoma efficacy and ocular surface interference after combined phacoendoscopic cyclophotocoagulation (CPC) and combined phacotrabeculectomy (CPT) in the treatment of primary angle closure glaucoma (PACG). Methods　A total of 101 patients (101 eyes) suffered from PACG complicated with cataract were divided into two groups according to surgical methods, and 46 patients (46 eyes) received CPC were in CPC group, and the other 55 patients (55 eyes) undergoing CPT were in CPT group. The contralateral eye of the surgery one was defined as self-control. Data related to anti-glaucoma effect, for example intraocular pressure (IOP) at entrance, on day 1 and the 4th week post-surgery, and anti-glaucoma drugs at entrance and 4th week post-surgery were collected for further comparison. In addition, ocular surface indexes including ocular surface disease index (OSDI), tear meniscus height (TMH), first noninvasive tear breakup time (NIBUTf) and average non-invasive tear film break-up time (NITBUTav) were applied to evaluate ocular surface status. The indexes were compared within group between surgical eyes and their contralateral ones while the deviations derived from surgical eyes and contralateral ones were compared between groups.Results　On day 1 after surgery, the IOP of surgical eyes was (21.6±3.2) mmHg (1 kPa=7.5 mmHg) in the CPC group compared with (13.8±4.1) mmHg in CPT group (P=0.00). At the 4th week after surgery, the IOP of surgical eyes was (14.0±2.8) mmHg in CPC group and (14.4±3.2)mmHg in CPT, no statistically difference was found (P=0.46). In addition, the difference in quantity of anti-glaucoma drugs at 4th week post-surgery between the two groups was of no statistical significance (P=0.53). For ocular surface evaluation, the indexes of surgical eyes and contralateral ones in CPC group at 4th week post-surgery were shown as follows:OSDI:(35.52±11.54) points vs. (24.70±9.09) points, TMH:(0.28±0.11) mm vs. (0.37±0.14) mm, NIBUTf:(7.54±3.32) s vs. (13.77±4.05) s, NITBUTav:(10.77±3.10)s vs. (16.75±3.77) s, and the differences were statistically significant (all P=0.00), while indexes of surgical eyes and its contralateral ones in CPT group were as follows:OSDI:(42.02±10.55) points vs. 22 (18, 27) points, TMH:(0.17±0.08) mm vs. (0.32±0.12) mm, NIBUTf:(5.13±2.00) s vs. (13.96±4.39) s, NITBUTav:(8.41±2.39) s vs. (16.33±4.83) s, and the differences were statistically significant (all P=0.00). Furthermore, the differences in the deviations from surgical eyes and contralateral eyes were of statistically significance (all P＜0.05).Conclusion　CPC contributes similar efficacy with CPT to PACG in IOP control, and it poses less damage to the ocular surface and be more beneficial to ocular comfort of post-surgery patients in contrast to CPT.