超声乳化白内障吸除联合Ex—PRESS植入治疗原发性闭角型青光眼合并白内障临床观察  

Clinical observation of phacoemulsification combined with Ex-PRESS implantation in the treatment of primary angle closure glaucoma with cataract

作　　者：陈春林[1] 叶剑[1] 

机构地区：[1]第三军医大学第三附属医院眼科,重庆400042

出　　处：《中国实用眼科杂志》2016年第10期1072-1076,共5页Chinese Journal of Practical Ophthalmology

摘　　要：【摘要】目的探讨超声乳化白内障吸除联合Ex—PRESS青光眼引流钉植入术用于原发性闭角型青光眼合并白内障的安全性和有效性。方法前瞻性临床病例对照研究，对2013年1月至2015年6月，入住第三军医大学第三附属医院眼科的原发性闭角型青光眼合并白内障病人，采用随机数字表法分为两组，其中试验组28例30只眼，行白内障超声乳化吸除及囊袋内人工晶状体植入联合Ex—PRESS引流钉植入术；对照组24例28只眼，行超声乳化白内障吸除及人工晶状体囊袋内植入联合小梁切除术，比较两组患者眼压、手术时间、以及房角开放距离（AOD500）、小梁虹膜角（TIA）、小梁睫状体距离（TCPD）和并发症情况。结果试验组和对照组均能有效降低眼压，两组间比较差异无统计学意义（P〉0．05）；试验组平均手术时间和并发症发生率明显少于对照组，差异有统计学意义（P〈0．05）；试验组和对照组在术后房角开放距离、小梁虹膜角、小梁睫状体距离均大于术前，差异有显著统计学意义（P〈0．01），但两组间比较差异无统计学意义（P〉0．05）。结论超声乳化白内障吸除术后，前房加深，房角开放，适合Ex—PRESS引流钉植入，超声乳化白内障吸除联合Ex—PRESS青光眼引流钉植入术用于闭角型青光眼合并白内障的手术是安全而有效的。Objective To observe the safety and efficacy of phacoemulsification combined with Ex-PRESS glaucoma drainage implantation for primary angle closure glaucoma with cataract. Meth- ods A randomized prospective clinical case-control study, patients with primary angle closure glauco- ma combined with cataract surgery from January 2013 to June 2015 in the department of ophthalmol- ogy of the third affiliated hospital of the third military medical university, random number table method was used to classify into two groups, 28 cases （30 eyes） were treated with phacoemulsifica- tion and intraocular lens implantation combined with Ex-PRESS glaucoma drainage implantation, 24 cases （28 eyes） were treated with phacoemulsification and intraocular lens implantation combined with trabeculectomy. The intraocular pressure, intraocular pressure, average operation time, open dis- tance （AOD 500）, trabecular iris angle （TIA）, trabecular-ciliary process distance （TCPD） and compli- cations were compared. Results Both the experiment group and the control group there was no sig- nificant difference on the intraocular pressure between the experimental group and control group, but there was no significant difference between the two groups. The average operation time and compli- cation rate of the experimental group was significantly less than that of the control group （P 〈0.001; P 〈0.05）. The difference was statistically significant （P 〈0.001）, but there was no significant difference between the experimental group and the control group （P 〉0.05）. Conclusions After phaco- emulsification, anterior chamber depth, opening of the anterior chamber angle, suitable for the Ex-PRESS drainage and implantation of the Ex-PRESS, the operation of the combined phacoemulsifi- cation and trabeculectomy combined with glaucoma drainage for the closure of glaucoma with cata- ract surgery is safe and effective.

关 键 词：白内障 原发性闭角型青光眼 超声乳化白内障吸除术 青光眼引流植入物 小梁切除术 

分 类 号：R775[医药卫生—眼科]