原发性闭角型青光眼合并白内障两种手术方式疗效研究

目的：比较单纯小梁切除术和青光眼白内障联合手术(青白联合手术)治疗原发性闭角型青光眼(primary angle-closure glaucoma ，PACG)合并白内障的效果。

方法：回顾性分析我院2010-01/2013-10间收治的PACG合并白内障患者80例90眼，分为观察组(青白联合手术组，45眼)和对照组(单纯小梁切除术组，45眼)。术后对所有患者随访6mo，观察术后眼压、视力以及术后并发症等情况。

结果：两组术后眼压比术前眼压均明显的降低，而观察组眼压降低更明显(P=0.003)。观察组患者术后视力明显上升，而对照组术后视力与术前上升不明显，两组对比差异有统计学意义(P=0.036)。对照组术后发生低眼压性浅前房、黄斑水肿、前房炎症的患眼均较观察组多，差异均有统计学意义(P=0.002，P=0.003，P=0.001)。

结论：对PACG合并白内障的患者行青白联合手术治疗能有效提高视力，控制眼压，且并发症少。

Effect of two surgical treatments for primary angle-closure glaucoma combined with cataract

AIM: To compare the effect of trabeculectomy and combined surgery of glaucoma and cataract treating primary angle-closure glaucoma(PACG)with cataract.

METHODS:It was retrospectively reviewed that 80 patients(90 eyes)with PACG and cataract were treated in our hospital from January 2012 to October 2013. They were divided into observation group(combined surgery of glaucoma and cataract group, 45 eyes)and control group(trabeculectomy group, 45 eyes). Postoperatively, all the patients were followed up for 6mo. Intraocular pressure(IOP), visual acuity and complications were observed.

RESULTS: Compared to preoperative IOP, postoperative IOP was significantly reduced in both observation group and control group, while IOP was reduced more greatly in observation group(P=0.003). Visual acuity was significantly improved in observation group, while it was not improved significantly in control group(P=0.036). Compared to control group, complications such as shallow anterior chamber with hypotony, macular edema and anterior chamber inflammation were less observed in observation group, with significant statistical difference(P=0.002, P=0.003, P=0.001).

CONCLUSION: For patients with PACG and cataract,combined surgery of glaucoma and cataract is an effective surgery that can improve visual acuity and reduce IOP with fewer complications.