小切口隧道内小梁切除术治疗白内障合并青光眼的疗效

目的：分析小切口隧道内小梁切除术在白内障合并青光眼手术中的应用价值及疗效。
　　方法：选取2013-05/2015-05在本院行手术治疗的青光眼合并白内障患者82例90眼,均行小切口隧道内小梁切除术治疗,比较患者手术前后不同时间点的眼压和屈光度的差异；分析患者术后视力改善情况以及总结手术的并发症发生情况。
　　结果：术后1、7d,1、6mo 时的眼压分别为19.38±3.63、12.96±2.84、11.37±1.05、11.89±0.82mmHg均低于术前眼压32.65±6.42mmHg,差异具有统计学意义(P<0.05)；术后患者垂直方向角膜屈光度先上升后下降,且各时间点均高于术前,差异具有统计学意义(P<0.05)；术后患者水平方向角膜屈光度先下降后上升,除术后1 mo外术后各时间点的水平方向角膜屈光度与术前的差异均具有统计学意义(P<0.05)；患者术后6mo 时视力≤0.1者5眼(6%),>0.1~0.5者48眼(53%),0.6~0.9者29眼(32%),≥1.0者8眼(9%),与术前比较明显提高,差异具有统计学意义(P<0.05)。术后前房积血3眼,角膜水肿5眼,前房纤维样渗出3眼,经对症处理后均在7d内恢复正常。
　　结论：小切口隧道内小梁切除术治疗白内障合并青光眼的疗效显著,安全性高。

Effect of small incision trabeculectomy for cataract patients with glaucoma

AIM:To study the application value and therapeutic effect of small incision trabeculectomy in tunnel in cataract combined with glaucoma surgery.

METHODS:Eighty-two patients of ninety eyes with cataract combined with glaucoma were selected in our hospital from May 2013 to May 2015, all of them treatment of small incision trabeculectomy in tunnel surgery, compare the difference of intraocular pressure and refractive degree at different time points before and after operation; To analyze the improvement of visual acuity after surgery and the occurrence of complications.

RESULTS:The intraocular pressure of postoperative 1, 7d, 1 and 6mo(19.38±3.63, 12.96±2.84, 11.37±1.05, 11.89±0.82mmHg)were lower than preoperative(32.65±6.42mmHg), and the difference has statistical significance(P<0.05). The vertical corneal refraction first increased and then decreased after the operation. The difference time points were higher than the preoperative, the difference was statistically significant(P<0.05). The horizontal corneal refraction first decreased and then increased after surgery. The horizontal corneal refraction at each time point except 1mo after surgery and preoperative differences were statistically significant. Five eyes(6%)of patients with vision <0.1 after 6mo of operation, forty-eight eyes(53%)with vision 0.1-0.5, 29 eyes(32%)with vision 0.6-0.9, eight eyes(9%)with vision >1.0, the vision was significantly improved after 6mo of operation(P<0.05). There were 3 eyes of patients with anterior chamber, 5 eyes had corneal edema, 3 eyes had the appearance of anterior chamber, and recovered within 7d after treatment.

CONCLUSION:The small incision trabeculectomy in tunnel for cataract combined with glaucoma has significant curative effect, higher safety, and highly clinical value.