超声乳化联合小梁切除术或房角分离术治疗合并白内障的慢性原发性闭角型青光眼  

Phacoemulsification with trabeculectomy or goniosynechialysis for chronic primary angle-closure glaucoma with cataract

作　　者：苟文军[1] 杨旭[1] 方晏红[1] 刘灵琳 龙波[1] 刘思源[1] 

机构地区：[1]遂宁市中心医院眼科,四川省遂宁市629000

出　　处：《眼科新进展》2015年第9期884-886,共3页Recent Advances in Ophthalmology

摘　　要：目的 对比观察白内障超声乳化联合小梁切除术与白内障超声乳化联合房角分离术治疗合并白内障的慢性原发性闭角型青光眼的临床疗效。方法 选择合并白内障的慢性原发性闭角型青光眼患者100例100眼分为2组,A组50例50眼施行白内障超声乳化吸出加人工晶状体植入联合小梁切除术,B组50例50眼施行白内障超声乳化吸出加人工晶状体植入联合房角分离术。术后随访12个月,记录并比较患者术前及术后12个月的最佳矫正视力、眼压、前房深度及并发症情况。结果 A组、B组术后12个月的最佳矫正视力分别为0.70±0.17和0.69±0.14,均较术前的0.27±0.02和0.26±0.04明显提高,差异均有统计学意义（均为P〈0.01）。A组、B组术后12个月的眼压分别为（14.93±2.97）mm Hg（1 k Pa=7.5 mm Hg）和（14.82±3.01）mm Hg,均较术前的（36.62±3.30）mm Hg和（37.18±2.96）mm Hg明显降低,差异均有统计学意义（均为P〈0.01）;但B组有27眼眼压高于21 mm Hg,需加用1-2种降眼压药物才能将眼压控制在正常范围。A组、B组术后12个月的前房深度分别为（4.56±0.04）mm和（4.60±0.07）mm,均较术前的（1.46±0.25）mm和（1.44±0.27）mm明显加深,差异均有统计学意义（均为P〈0.01）。A组、B组术后12个月最佳矫正视力、眼压及前房深度的比较差异均无统计学意义（均为P〉0.05）。A组术后13眼出现浅前房,1眼前房少许出血,3眼发生恶性青光眼;B组术后未见浅前房等并发症发生。结论 白内障超声乳化联合小梁切除术与白内障超声乳化联合房角分离术均能有效控制慢性原发性闭角型青光眼患者眼压、提高视力。Objective To observe the clinical efficacy of phacoemulsification with trabeculectomy or goniosynechialysis for chronic primary angle-closure glaucoma with cataract.Methods One hundred eyes of 100 chronic primary angle-closure glaucoma with cataract patients were divided into two groups randomly,group A underwent phacoemulsification with trabeculectomy,group B underwent phacoemulsification with goniosynechialysis,50 cases（50eyes） in each group.All patients were followed-up for 12 months.The best corrected visual acuity,intraocular pressure,anterior chamber depth and complication were recorded and compared between pre-operation and postoperative 12 months.Results The best corrected visual acuity at postoperative 12 months in group A and group B were 0.70±0.17 and 0.69±0.14,respectively,were significantly higher than preoperative 0.27±0.02 and 0.26±0.04（all P〈0.01）.The intraocular pressure at postoperative 12 months in group A and group B were（14.93±2.97） mmHg（1 kPa=7.5 mmHg）and（14.82±3.01） mmHg,respectively,were significantly lower than preoperative（36.62±3.30） mmHg and（37.18±2.96） mmHg（all P〈0.01）.But the intraocular pressure in 27 eyes was greater than 21 mmHg,and needed to add 1 to 2 kinds of antihypertensive drugs in order to control the intraocular pressure in the normal range.The anterior chamber depth at postoperative 12 months in group A and group B were（4.56±0.04） mm and（4.60±0.07） mm,respectively,were significantly deeper than preoperative（1.46±0.25）mm and（1.44±0.27） mm（all P〈0.01）.The difference in best corrected visual acuity,intraocular pressure and anterior chamber depth was not statistical significant between group A and group B（all P〉0.05）.In group A,the shallow anterior chamber appeared in13 eyes,few hyphema in 1 eye,and malignant glaucoma in 3 eyes;No above complication appeared in group B.Conclusion Both phacoemulsification with trabeculectomy and phacoemulsification with goniosynechialysis for chronic primary angle-clos

关 键 词：白内障超声乳化 小梁切除术 房角分离术 慢性原发性闭角型青光眼 

分 类 号：R779.66[医药卫生—眼科]