超声乳化术联合前房角分离与小梁切除术治疗青光眼伴白内障的疗效比较  

The comparison of clinical efficacy between phacoemulsification combined with goniosynechialysis and phacoemulsification combined with trabeculectomy for chronic angle-closure glaucoma with cataract

作　　者：冯希敏[1] 祁颖[2] 张凤妍[2] 赵庆新[1] 秦云凤[1] 

机构地区：[1]新乡市中心医院眼科,河南453000 [2]郑州大学第一附属医院眼科,郑州450052

出　　处：《中华眼外伤职业眼病杂志》2017年第1期31-35,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的 比较采用超声乳化联合前房角分离术与超声乳化联合小梁切除术两种手术方法治疗伴发年龄相关性白内障的原发性慢性闭角型青光眼的效果.方法 回顾性分析我院原发性慢性闭角型青光眼伴发年龄相关性白内障29例（40只眼）的临床资料.患者随机分为两组,A组15例（21只眼）手术方式为超声乳化＋人工晶状体植入＋前房角分离术;B组14例（19只眼）手术方式为超声乳化＋人工晶状体植入＋小梁切除术.术前视力、眼压、前房深度及前房角宽度两组之间的差异均无统计学意义（P＞0.05）.结果 术后1、3、6及12个月：视力及前房深度两组之间的差异均无统计学意义（P＞0.05）,前房角宽度A组均较B组大,差异有统计学意义（P＜0.0 5）,术后1、3及6个月时眼压的差异均无统计学意义,但术后12个月时,A组眼压较B组眼压高,差异有统计学意义（P=0.017）.术后各时间点上述各项指标两组均优于术前（P＜0.05）.两组术后12个月内复发率比较,差异无统计学意义（P＞0.05）.结论 治疗伴发年龄相关性白内障的原发性慢性闭角型青光眼两种手术方式疗效均较确切.但B组远期效果优于A组.Objective To compare the efficacy between phacoemulsification combined with goniosynechialysis and phacoemulsification combined with trabeculectomy for chronic angle-closure glaucoma with age related cataract.Methods The clinical data of 40 eyes of 29 patients with chronic angle-closure glaucoma with age-related cataract were collected from March 2012 to July 2014 in our hospital.The patients were divided into two groups randomly.Group A,with 21 eyes of 15 cases,were treated by phacoemulsification and combined with goniosynechialysis.Group B,with 19 eyes of 14 cases,were treated by phacoemulsification combined with trabeculectomy.In two groups,the preoperative visual acuity,intraocular pressure,anterior chamber depth and anterior chamber angle had no statistical difference （P 〉0.05）.Results In two groups：the difference at 1,3,6 and 12 months in postoperative visual acuity and anterior chamber depth were not statistically significant （P 〉 0.05）.The angle of anterior chamber in Group A was wider than that in Group B （P 〈 0.05）.And the difference at 1,3 and 6 months after Surgery in intraocular pressure were not significant （P 〉 0.05）.But the intraocular pressure of the group A was higer than the group B at 12 months,after surgery the difference had statistically significant （P =0.017）.The above indexes in two groups at each time points after operation were improved compared with those of at preoperation （P 〈 0.05）.The difference in recurrence rate between the two groups were statistically significant （P 〉 0.05）.Conclusion There are good clinical efficacy about phacoemulsification with goniosynechialysis and phacoemulsification with trabeculectomy for chronic angle-closure glaucoma with age related cataract,but the long-term efficacy of group B is better than that of group A.

关 键 词：青光眼 闭角性 慢性 白内障 年龄相关性 超声乳化 前房角分离术 小梁切除术 

分 类 号：R779.6[医药卫生—眼科]