无缝线巩膜隧道瓣小梁切除联合白内障超声乳化人工晶体植入术治疗青光眼合并白内障的临床疗效  

Glaucoma and Cataract: Clinical Efficacy of Scleral Tunnel Sutureless Trabeculectomy plus Phacoemulsification and Intraocular Lens Implantation

作　　者：夏伟[1] 袁非[1] 杨志坤[1] 马晓萍[1] 张雪岩[1] 

机构地区：[1]复旦大学附属中山医院青浦分院,上海201700

出　　处：《现代生物医学进展》2015年第29期5719-5723,共5页Progress in Modern Biomedicine

基　　金：上海市重点学科建设资助项目(S30205)

摘　　要：目的:探讨无缝线巩膜隧道瓣小梁切除术与白内障超声乳化人工晶体(IOL)植入术联合治疗青光眼伴白内障患者的疗效。方法:将88例青光眼伴白内障患者,随机分为观察组与对照组,44例每组。观察组行无缝线巩膜隧道瓣小梁切除术+白内障超声乳化摘除术+IOL植入术,对照组行经典小梁切除术+白内障超声乳化摘除术+IOL植入术,对比两组的疗效。结果:术后6个月,观察组视力提高率为86.36%,视力>0.5率为81.82%,显著高于对照组的72.73%、68.18%(P<0.05);观察组术后眼压和散光度显著低于对照组(P<0.05);观察组的功能滤泡形成率为84.09%,显著高于对照组的70.45%(P<0.05);观察组术后角膜内皮细胞丢失率为4.629%,显著低于对照组的14.760%(P<0.05);观察组的并发症发生率为4.55%,显著低于对照组的22.73%(P<0.05)。结论:无缝线巩膜隧道瓣小梁切除术与白内障超声乳化IOL植入术联合治疗青光眼伴白内障较经典三联术式具有更好的疗效,可有效改善视力、降低眼压、保护角膜内皮、降低术后并发症,值得推广应用。Objective： To investigate the effect of scleral tunnel sutureless trabeculectomy combined with phacoemulsification and intraocular lens（IOL） implantation in the treatment of patients with glaucoma and cataract. Methods： A total of 88 patients with glaucoma and cataract were randomly divided into observation group（n=44） and control group（n=44）. The observation group underwent scleral tunnel sutureless trabeculectomy plus phacoemulsification plus IOL implantation, while the control group underwent trabeculectomy plus phacoemulsification plus IOL implantation. The efficacy of the two groups was compared. Results： Six months after operation, the visual acuity improved rate（86.36%） and vision〉0.5 rate（81.82%） in the observation group were, significantly higher than that（72.73%） and that（68.18%） in the control group（P〈0.05）. The postoperative intraocular pressure and astigmatism in the observation group were significantly lower than those in the control group（P〈0.05）. The functional follicles rate（84.09%） in the observation group was significantly higher than that（70.45%） in the control group（P〈0.05）. The corneal endothelial cell loss rate（4.629%） in the observation group was significantly lower than that（14.760%） in the control group（P〈0.05）. The incidence of complications（4.55 %） in the observation group was significantly lower than that（22.73%） in the control group（P〈0.05）. Conclusions： In the treatment of patients with glaucoma and cataract,scleral tunnel sutureless trabeculectomy combined with phacoemulsification and IOL implantation has a better efficacy compared with the classical triple procedure and can effectively improve vision, reduce intraocular pressure, protect the corneal endothelium and reduce postoperative complications, which is worthy of clinical application.

关 键 词：青光眼 白内障 超声乳化吸除术 人工晶体植入术 小梁切除术 巩膜隧道瓣 

分 类 号：R776[医药卫生—眼科]