小切口白内障摘除治疗急性闭角型青光眼合并白内障

目的：探讨小切口白内障摘除用于治疗急性闭角型青光眼合并白内障患者的临床疗效与价值。

方法：选取2012-05/2013-11我院收治的60例急性闭角型青光眼合并白内障患者作为观察对象，随机分为A组、B组、C组，每组各20例。A组行抗青光眼手术治疗，B组采用青光眼白内障联合手术，C组采用单纯小切口白内障摘除联合人工晶状体植入术治疗。观察三组患者术前、术后眼压、前房深度、前房角、视乳头C/D比值改变及矫正视力、并发症的发生、住院时间、成本效益及学习曲线等指标。

结果：三组患者入院时及用药后眼压均无明显差别(P>0.05)； 经不同手术方式后，C组眼压显著优于A组和B组(P<0.05)； 不同手术后，患者矫正视力均发生改变，A组和B组比较差异无显著性(P>0.05)，C组明显优于A组和B组(P<0.05)； A组和B组并发症比较，差异无显著性(P>0.05)，C组并发症明显少于A组和B两组(P<0.05)。

结论：小切口白内障摘除术治疗急性闭角型青光眼恢复时间快，创口小，疗效显著且并发症少，能够有效提高疾病治愈率，改善患者生活质量，无需昂贵的医疗设备，学习曲线短，费用低，值得临床推广使用。

Clinical study on small incision cataract extraction in treatment of acute angle-closure glaucoma with cataract

AIM: To investigate the clinical curative effects and value of small incision cataract extraction in the treatment of acute angle-closure glaucoma and cataract.

METHODS: A total of 60 cases of acute angle-closure glaucoma with cataract patients in our hospital from May 2012 to November 2013 were selected as the study objects, and randomly divided into Group A, B and C, each group contained 20 cases(eyes). Group A were given anti-glaucoma surgery, Group B were given glaucoma and cataract surgery, while Group C were given simple small incision cataract extraction and intraocular lens implantation. The IOP, anterior chamber depth, anterior chamber angle, papilledema C / D ratio change, and corrected visual acuity, complications, hospital stay, cost-effectiveness and the learning curve and other indicators before and after the treatment of these three groups were compared.

RESULTS: Three groups of patients on admission and there was no significant difference in IOP after treatment(P>0.05); through different surgical methods, IOP of group C was significantly better than that in group A and group B(P<0.05); after surgery, the difference of patients with correction change in visual acuity between group A and group B was not significant(P>0.05), while group C was significantly better in group A and group B(P<0.05); compared the complications of group A and group B, there was no significant difference(P>0.05), group C had significantly less complications than group A and group B(P<0.05).

CONCLUSION: The small incision cataract surgery for acute angle-closure glaucoma has faster recovery, a small wound, a significant effect and fewer complications. It can effectively improve the cure rate of the disease and improve patient quality of life. Medical equipment is not expensive, the learning curve is short, the cost is low, and it is worthy of clinical use.