两种术式治疗闭角型青光眼合并白内障的比较

目的比较青光眼白内障联合手术与单纯小梁切除术治疗青光眼合并白内障的临床疗效。方法选择2009年1月～2011年12月四川省南充市中心医院眼科收治的青光眼合并白内障患者128例（128眼），分为A组（青白联合手术组，n=52）和B组（单纯小梁切除术组，n=76）。术后随访6个月，观察治愈率、眼压、术后视力、术后并发症等情况。结果术后6个月，A组患者治愈率为90．4％，B组患者治愈率为86．8％．两组治愈率比较，差异无统计学意义（P〉0．05）。两组术后眼压分别较术前均有明显下降，差异均有高度统计学意义（均P〈0．01），但两组间术后眼压差异无统计学意义（P〉0．05）。A组术后视力较术前有明显好转，差异有高度统计学意义（P〈0．01）；B组术后视力与术前比较，差异无统计学意义（P〉0．05）；两组间术后视力比较，A组优于B组，差异有统计学意义（P〈0．05）。A组术后并发症发生率为19．2％（10／52）1，与B组14．5％（11／76）1比较，差异无统计学意义（P〉0．05）。结论对于有白内障手术指征的青光眼患者，选择青白联合手术治疗青光眼合并白内障手术安全、临床效果显著，而且术后视力恢复快，提高了患者的生活质量。

Comparison of two surgical procedures in the treatment of primary angle-closure glaucoma with coexisting cataract

Objective To compare the clinical efficacy and safety of glaucoma with cataract phacotrabeculectomy and simple trabeculectomy in the treatment of primary angle-closure glaucoma （PACG） with coexisting cataract. Methods 128 patients （128 eyes） of PACG with coexisting cataract in Department of Ophthalmology of Central Hospital in Nan- ehong City of Sichuan Province from January 2009 to December 2011 were selected and divided into group A （com- bined phacotrabeculectomy group, n = 52） and group B （trabeculectomy group, n = 76）. Cases were followed up for 6 months. Recovery rate, intraocular pressure （lOP）, postoperative visual acuity and complications were compared. Re- sults Recovery rate in group A was 90.4% 6 months after the operation, and was 86.8% in group B, the difference was not statistically significant （P 〉 0.05）. IOP in the two groups after the operation were all lower than those before the treatment respectively, the differences were all statistically significant （all P 〈 0.01）. Postoperative visual acuity in group A was better than that before the treatment, the difference was statistically significant （P 〈 0.01）; the difference of postoperative visual acuity in group B was not statistically significant with the prior treatment （P 〉 0.05）; postopera- tive visual acuity in group A was better than that in group B, the difference was statistically significant （P 〈 0.05）. The difference of occurrence rate of complications in group A 19.2% （10/52）] and group B 14.5% （11/76）] was not statis- tically significant （P 〉 0.05）. Conclusion Combined phacotrabeculectomy treatment can reduce lOP and simultaneous- ly increase visual acuity for patients with PACG coexisting cataract. It＇s efficacy, safety, and could improve the life quality of patient.