基于房角关闭程度的手术方法治疗闭角型青光眼的临床疗效观察  

The effects observation of different surgery for treating angle-closure glaucoma based on the angle closure situation

作　　者：李璇[1] 刘茁[2] 张洪洋[3] 

机构地区：[1]湖北医药学院附属东风医院眼科,湖北十堰442000 [2]湖北医药学院附属东风医院口腔科,湖北十堰442000 [3]广东省人民医院眼科,广东广州510080

出　　处：《临床和实验医学杂志》2015年第8期667-669,共3页Journal of Clinical and Experimental Medicine

基　　金：广东省医学科研基金立项课题:选择性激光小梁成形术联合超声乳化手术治疗合并白内障的原发性闭角型青光眼(编号:A2014043)

摘　　要：目的探讨基于房角关闭程度的手术方法治疗闭角型青光眼的临床疗效。方法分析2012年8月到2014年9月收治的闭角型青光眼患者140例的临床资料,房角关闭>180°患者50例作为治疗组,而房角关闭≤180°患者90例作为对照组。对照组选择单纯小梁切除术,治疗组选择小梁切除术+白内障超声乳化吸出术。比较治疗后两组房角关闭程度、视力、眼压改善程度和并发症发生情况。结果所有患者均手术成功,两组治疗后的房角关闭程度均明显下降(P<0.05),且治疗组术后房角关闭程度较对照组对比下降更明显(P<0.05)。两组术后视力均明显提高,术后眼压均较术前有所下降,与术前比较,差异有统计学意义(P<0.05);但组间术后视力比较差异均无统计学意义(P>0.05),治疗组术后眼压明显低于对照组(P<0.05)。术后随访3个月,两组角膜水肿、一过性高眼压等并发症发生率差异无统计学意义(P>0.05)。结论小梁切除术+白内障超声乳化吸出术治疗闭角型青光眼患者能在提高视力与不增加并发症的基础上,更加有利于降低眼压与改善房角关闭程度,值得推广应用。Objective To investigate the effects of different surgery for treating angle- closure glaucoma based on the angle closure situation. Methods Selected 140 angle- closure glaucoma patients from August 2012 to September 2014 in our hospital for treatment,and the angle closure 〉180° as the treatment group of 50 patients,and the angle closure ≤180 ° as the control group of 90 patients,the control group were selected trabeculectomy,and the treatment group were selected trabeculectomy ＋ phacoemulsification cataract surgery. Results All patients were successful surgery,the degree of angle closure after treatment were significantly decreased（ P〈0. 05）,while the decreased values of angle closure in the two groups compared were significant difference（ P〈0. 05）. The postoperative visual acuity and intraocular pressure were significantly improved and compared with preoperative were significant differences（ P〈0. 05）,and the postoperative visual acuity compared between the two groups were showed no significant difference（ P〉0. 05）. The postoperative intraocular pressure compared between the two groups were showed significant difference（ P〈0. 05）. Patients were followed up for 3 months,there were serious complications of hyphema,choroidal detachment.The corneal edema,transient ocular hypertension and other complications were no statistically significant differences compared in the two groups（P〉0. 05）,after symptomatic treatment were significantly improved. Conclusion Trabeculectomy ＋ phacoemulsification cataract surgery in patients with angle- closure glaucoma therapy can improve visual acuity and do no increase in complications,it can more help reduce intraocular pressure and improve the degree of angle closure that should be widely applied.

关 键 词：闭角型青光眼 房角关闭 并发症 小梁切除术 白内障超声乳化 

分 类 号：R779.6[医药卫生—眼科]