三种手术方式在合并白内障的原发性急性闭角型青光眼中的疗效对比(1)
摘 要：目的 探究在合并白內障的原发性急性闭角型青光眼临床治疗中复合式小梁手术、青光眼白内障联合手术以及超声乳化的疗效对比。方法 选取2016年4月～2018年4月我院收治的58例(76眼)原发性急性闭角型青光眼合并白内障患者，按手术治疗方法分为单纯抗青光眼组(20例28眼)、超声乳化组(15例25眼)和青白联合手术组(23例23眼)。单纯抗青光眼组患者行复合式小梁切除术，超声乳化组患者行超声乳化白内障吸出+折叠人工晶体植入术，青白联合手术组行小梁切除术+周边虹膜切除术+超声乳化白内障吸出+折叠人工晶体植入术。比较三组患者视力、眼压、前房深度、术后并发症情况。结果 治疗后，超声乳化组及青白联合组视力均有提高[(0.22±0.05)D vs(0.77±0.11)D，(0.23±0.05)D vs (0.55±0.09)D](P<0.05)；治疗后三组患者眼压水平均有所改善[(49.40±8.25)mmHg vs(16.25±2.34)mmHg，(49.31±8.20)mmHg vs (17.15±2.42)mmHg，(50.51±8.30)mmHg vs (17.25±2.53)mmHg](P<0.05)；单纯抗青光眼组前房深度加深幅度较小[(1.65±0.22)mm vs(2.96±0.50)mm](P<0.05)，超声乳化组及青白联合组前房深度加深[(1.64±0.20)mm vs(3.68±0.70)mm，(1.66±0.24)mm vs (3.53±0.67)mm](P<0.05)。超声乳化组患者术后并发症发生率低于青白联合组及单纯抗青光眼组(0 vs 17.39% vs 17.86%)(P<0.05)。结论 临床上需要根据PACG合并白内障患者不同的房角情况选择不同的手术方式。
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关键词：超声乳化；青光眼白内障联合手术；白内障；原发性闭角型青光眼
中图分类号：R779.6 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.22.030
文章编号：1006-1959(2018)22-0110-03
Comparison of the Effect of Three Surgical Methods in the Treatment of Primary Angle Closure Glaucoma with Cataract
RAO Li-na
(Department of Ophthalmology，the Affiliated Hospital of Jiujiang University， Jiujiang 332000， Jiangxi，China)
, 百拇医药
Abstract：Objective To investigate the efficacy of combined trabecular surgery， glaucoma cataract surgery and phacoemulsification in the clinical treatment of primary acute angle-closure glaucoma with cataract. Methods A total of 58 patients (76 eyes) with primary acute angle-closure glaucoma and cataract admitted to our hospital from April 2016 to April 2018 were enrolled. The patients were divided into the simple anti-glaucoma group (20 eyes and 28 eyes) according to the surgical treatment. The phacoemulsification group (15 cases of 25 eyes) and the combination of white and white surgery group (23 cases of 23 eyes).Patients underwent combined trabeculectomy in the glaucoma group alone，in the phacoemulsification group， phacoemulsification cataract extraction and folding intraocular lens implantation were performed.Combined trabeculectomy plus peripheral iridotomy + phacoemulsification cataract extraction and folding intraocular lens implantation in the combined operation group.The visual acuity， intraocular pressure， anterior chamber depth and postoperative complications were compared between the three groups.Results After treatment， the visual acuity of the phacoemulsification group and the combination group were improved [(0.22±0.05)D vs(0.77±0.11)D， (0.23±0.05)D vs (0.55±0.09)D](P<0.05)；After treatment， the intraocular pressure levels of the three groups were improved [(49.40±8.25)mmHg vs(16.25±2.34)mmHg， (49.31±8.20)mmHg vs (17.15±2.42)mmHg， (50.51±8.30)mmHg vs (17.25 ±2.53)mmHg](P<0.05)； the depth of anterior chamber depth in the simple antiglaucoma group was small [(1.65±0.22) mm vs (2.96±0.50) mm](P<0.05)，The depth of the anterior chamber of the phacoemulsification group and the combination group was significantly deeper [(1.64±0.20) mm vs (3.68±0.70) mm， (1.66±0.24) mm vs (3.53±0.67) mm](P<0.05). The incidence of postoperative complications in the phacoemulsification group was lower than that in the combination group and the anti-glaucoma group (0 vs 17.39% vs 17.86%)(P<0.05). Conclusion It is necessary to choose different surgical methods according to the different angles of PACG combined with cataract patients., 百拇医药(饶丽娜)
, http://www.100md.com
关键词：超声乳化；青光眼白内障联合手术；白内障；原发性闭角型青光眼
中图分类号：R779.6 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.22.030
文章编号：1006-1959(2018)22-0110-03
Comparison of the Effect of Three Surgical Methods in the Treatment of Primary Angle Closure Glaucoma with Cataract
RAO Li-na
(Department of Ophthalmology，the Affiliated Hospital of Jiujiang University， Jiujiang 332000， Jiangxi，China)
, 百拇医药
Abstract：Objective To investigate the efficacy of combined trabecular surgery， glaucoma cataract surgery and phacoemulsification in the clinical treatment of primary acute angle-closure glaucoma with cataract. Methods A total of 58 patients (76 eyes) with primary acute angle-closure glaucoma and cataract admitted to our hospital from April 2016 to April 2018 were enrolled. The patients were divided into the simple anti-glaucoma group (20 eyes and 28 eyes) according to the surgical treatment. The phacoemulsification group (15 cases of 25 eyes) and the combination of white and white surgery group (23 cases of 23 eyes).Patients underwent combined trabeculectomy in the glaucoma group alone，in the phacoemulsification group， phacoemulsification cataract extraction and folding intraocular lens implantation were performed.Combined trabeculectomy plus peripheral iridotomy + phacoemulsification cataract extraction and folding intraocular lens implantation in the combined operation group.The visual acuity， intraocular pressure， anterior chamber depth and postoperative complications were compared between the three groups.Results After treatment， the visual acuity of the phacoemulsification group and the combination group were improved [(0.22±0.05)D vs(0.77±0.11)D， (0.23±0.05)D vs (0.55±0.09)D](P<0.05)；After treatment， the intraocular pressure levels of the three groups were improved [(49.40±8.25)mmHg vs(16.25±2.34)mmHg， (49.31±8.20)mmHg vs (17.15±2.42)mmHg， (50.51±8.30)mmHg vs (17.25 ±2.53)mmHg](P<0.05)； the depth of anterior chamber depth in the simple antiglaucoma group was small [(1.65±0.22) mm vs (2.96±0.50) mm](P<0.05)，The depth of the anterior chamber of the phacoemulsification group and the combination group was significantly deeper [(1.64±0.20) mm vs (3.68±0.70) mm， (1.66±0.24) mm vs (3.53±0.67) mm](P<0.05). The incidence of postoperative complications in the phacoemulsification group was lower than that in the combination group and the anti-glaucoma group (0 vs 17.39% vs 17.86%)(P<0.05). Conclusion It is necessary to choose different surgical methods according to the different angles of PACG combined with cataract patients., 百拇医药(饶丽娜)