不同切口闭角型青光眼白内障三联手术近期疗效比较  

Comparison of the short term therapeutic effects by different incision triple surgery in treating angle-closure glaucoma with cataract

作　　者：施妍霞[1] 王辉[2] 李秋硕[1] 

机构地区：[1]中国辽宁省铁岭市中心医院眼科,112000 [2]中国辽宁省沈阳市第四人民医院眼科,110031

出　　处：《国际眼科杂志》2013年第12期2510-2513,共4页International Eye Science

摘　　要：目的：探讨单切口与双切口超声乳化白内障吸除折叠式人工晶状体植入联合青光眼小梁切除术治疗闭角型青光眼并发白内障的疗效比较。 方法：回顾性分析70例98眼青光眼小梁切除联合白内障超声乳化摘除人工晶状体植入术病例。其中单切口术式的病例有34例50眼，双切口的有36例48眼。分析比较两组患者的术后眼压控制、滤过泡情况，术前和术后1mo的角膜内皮细胞密度和面积及并发症情况。随访12～24（平均18．2）mo。 结果：术后平均眼压单切口组10．16±4．31mmHg、双切口组11．38±3．55mmHg，两组术式平均眼压下降差异无统计学意义（P＞0．05）。术后滤过泡形成两组比较差异无统计学意义（P＞0．05）。两组患者角膜内皮细胞密度和面积术前没有明显差异（P＞0．05），术后1mo双切口组明显高于单切口组（P＜0．01）。 结论：单切口和双切口不同术式的联合手术均具有较好的降眼压的作用，同时能维持良好的滤过泡功能。两组术式的降低眼压功能基本相同。双切口青光眼白内障三联手术在损失角膜内皮细胞方面比单切口术式更有优势。AIM：To compare the therapeutic effects of different incision phacoemulsification with foldable intraocular lens implantation combined with trabeculectomy in treating angle -closure glaucoma complicated with cataract. METHODS： The retrospective study analyzed 70 patients （ 98 eyes ） who performed phacoemulsification with foldable intraocular lens implantation combined with trabeculectomy.Single incision surgery （ one-site approach） was performed on 34 patients （50 eyes）, and double incision surgery （ two-site approaches） was done on 36 patients （ 48 eyes ） .The differences of intraocular pressure control, filtering bleb, the density and preservation of corneal endothelium cells both pre -surgery and 1 month post-surgery or later complication. in the two groups were compared and analyzed.Follow-up was 12-24 months with a mean of 18.2 months. RESULTS： The average postoperative intraocular pressure in one-site groups was （10.16±4.31）mmHg. The average postoperative intraocular pressure in two-site groups was （ 11.38 ±3.55 ） mmHg.There were no statistically significant differences between the two groups （P〉0.05） regarding the postoperative intraocular pressure and the formation of filtering blebs （ P〉0.05）. The density and area of corneal endothelium cells in the two-incision group pre-operation were comparable （ P〉0.05）.However, in 1 month post-operation, the rate of the corneal endothelial cells loss in double incision group was superior compared to the single incision group （ P〈0.01）. CONCLUSION：Both single incision and double incision approach phacotrabeculectomy are effective in reducing intraocular pressure and can maintain the function of filtering blebs well.There are no statistically significant differences in the intraocular pressure reduction between the two approaches. The double incision approach is superior in minimizing the corneal endothelial cells loss compared to the single incision approach.

关 键 词：白内障 闭角型青光眼 手术切口 角膜内皮细胞 

分 类 号：R779.6[医药卫生—眼科]