白内障超声乳化术治疗原发性闭角型青光眼合并白内障的临床观察

目的：研究白内障超声乳化术联合不同术式治疗原发性闭角型青光眼(PACG)合并白内障的临床疗效及安全性。

方法：PACG合并白内障患者34例47眼，分为两组：A组26眼(房角关闭粘连范围≤180°)行超声乳化术联合房角分离术，B组21眼(房角关闭粘连范围>180°)行超声乳化术联合小梁切除术。术后随访6mo，观察术后最佳矫正视力(BCVA)、眼压、前房深度、炎症反应、滤过泡及并发症。

结果：两组患者末次随访眼压分别为14.37±4.83和15.86±3.74mmHg，均较术前显著下降(P<0.01)，前房深度分别为3.53±0.37和3.63±0.35mm，较术前均显著加深(P<0.01)，组间差异无统计学意义。两组BCVA中值分别为0.6和0.5，较术前提高。两组术后均未见明显的并发症。

结论：选择白内障超声乳化术联合适合的青光眼术式治疗PACG，降眼压效果稳定，视力提高显著，术后并发症少，是有效安全的方法。

Clinical observation of phacoemulsification for primary angle-closure glaucoma coexisted with cataract

AIM: To investigate the clinical effects and safety of phacoemulsification combined with different glaucoma surgical procedures for primary angle-closure glaucoma(PACG)coexisted with cataract.

METHODS: Thirty-four cases(47 eyes)with PACG coexisted with cataract were divided into group A and group B. Group A was defined as the closed angle of anterior chamber was less than 180°and was treated with phacoemulsification combined with goniosynechialysis. Group B as the closed angle was more than 180° was treated with phacoemulsification combined with trabeculectomy. The follow-up period was 6mo. Postoperative best corrected visual acuity(BCVA), intraocular pressure(IOP), anterior chamber depth(ACD), filtration bleb and complications were observed.

RESULTS: The IOPs were 14.37±4.83 and 15.86±3.74mm Hg at final follow-up in group A and B respectively, which were significantly decreased compared with pre-surgery(P<0.01). Similarly, the ACDs were 3.53±0.37 and 3.63±0.35mm in group A and B respectively, both deeper than those of pre-surgery(P<0.01). There was no statistically significant difference of IOP or ACD between group A and B. The median BCVAs were 0.6 and 0.5 respectively, increased markedly than those of pre-surgery. There were no serious complications.

CONCLUSION: Phacoemulsification combined with anti-glaucoma surgery can get stable control on IOP, improve visual acuity,decrease the complication risk and is safe and effective.