超声乳化联合房角分离术与小梁切除术治疗急性闭角型青光眼合并白内障

目的：比较白内障超声乳化联合房角分离术与单纯小梁切除术治疗急性闭角型青光眼合并白内障的临床疗效。

方法：选取我院就诊的急性闭角型青光眼合并白内障患者46例60眼，其中行白内障超声乳化联合房角分离术30眼(A组)，单纯行小梁切除术30眼(B组)； 观察术后4、7d，1、3mo，患者BCVA(LogMAR视力)、眼压、中央前房深度及视野情况。

结果：术后3mo A组BCVA为0.20±0.18显著高于B组0.39±0.09(P<0.05)。 A组术前眼压(18.3±4.6mmHg)与术后3mo(17.2±1.9mmHg)无差异(P>0.05)； 术前B组眼压(18.2±5.0mmHg)与术后3mo(12.4±2.1mmHg)有差异(P<0.05)； 术后3mo，A组和B组眼压比较有差异(P<0.05)。术前A组前房深度(2.23±0.21mm)与术后3mo(3.46±0.10mm)，B组术前前房深度(2.21±0.12mm)与术后3mo(3.36±0.09mm)均有差异(P<0.05)。A组术前视野缺损度(6.32±1.57db)与术后3mo(6.54±1.42db)，B组术前视野缺损度(6.31±1.46db)与术后3mo(6.57±1.52db)均无差异(P>0.05)。

结论：白内障超声乳化联合房角分离术与单纯小梁切除术对急性闭角型青光眼眼压均能有效控制。

Comparison of phacoemulsification combined with angle separation and trabeculectomy in acute angle-closure glaucoma complicated with cataract

AIM: To compare the clinical efficacy of phacoemulsification combined with angle separation with trabeculectomy in the treatment of acute angle-closure glaucoma complicated with cataract.

METHODS: A total of 46 patients(60 eyes)diagnosed as acute angle-closure glaucoma complicated with cataract in our hospital from January 2016 to December 2017 were enrolled in this study. Thirty eyes were treated with phacoemulsification combined with chamber angle separation(group A). Thirty eyes were treated with trabeculectomy(group B). The visual acuity, intraocular pressure(IOP)and central anterior chamber depth were observed at preoperative and 4d, 7d, 1mo, 3mo postoperative.

RESULTS: The LogMAR visual acuity of group A(0.20±0.18)was significantly higher than that of group B(0.39±0.09)at 3mo postoperatively(P<0.05). Before operation, IOP in group A(18.3±5.0mmHg)was no difference to IOP(17.2±1.9mmHg)postoperatively(P>0.05). Before operation, IOP in group B(18.2±5.0mmHg)was significantly difference to IOP(12.4±2.1mmHg)postoperatively(P<0.05). There was a statistically significant difference in IOP between groups in 3mo after surgery(P<0.05). In group A, the preoperative anterior chamber depth(ACD)was 2.23±0.21mm. The ACD was 3.46±0.1mm at 3mo postoperatively. In group B, the preoperative ACD was 2.21±0.12mm. The ACD was 3.36±0.09mm at 3mo postoperatively. In group A, there was no significant difference between the preoperative visual field loss(6.32±1.57db)and the 3mo postoperatively(6.54±1.42db)(P>0.05). In group B, there was no significant difference between the preoperative visual field loss(6.31±1.46db)and the 3mo postoperatively(6.57±1.52db)(P>0.05).

CONCLUSION: In this study, phacoemulsification combined with angle separation and trabeculectomy are both effectively in controlling IOP of acute angle-closure glaucoma.