超声乳化白内障吸除术联合不同方式的房角粘连分离术治疗原发性闭角型青光眼合并白内障的疗效评估  

Efficacy Evaluation of Phacoemulsification Combined with Different Goniosynechialysis Surgery in Treatment of Primary Angle-closure Glaucoma Combined with Cataract

作　　者：葛红卫[1] 

机构地区：[1]如东县人民医院眼科,江苏如东226400

出　　处：《系统医学》2016年第9期29-32,37,共5页Systems Medicine

摘　　要：目的评估超声乳化白内障吸除术(PHACO)联合不同方式房角粘连分离术(GSL)对原发性闭角型青光眼(PACG)合并白内障的疗效及安全性。方法选取PACG合并白内障患者30例(42眼),均为该院眼科2011年10月—2014年10月收治,根据患者入院顺序随机划分为2组,其中A组(21例,29眼)采用PHACO联合撕囊前房角粘连分离术治疗,B组(9例,13眼)采用PHACO联合皮质吸除后房角粘连分离术治疗,对比2组治疗前及治疗后不同时段眼压、视力、前房深度、房角开放程度及并发症等指标的差异。结果治疗前,A组的眼压、视力及前房深度分别为(35.74±10.56)mm Hg、(0.13±0.07)、(1.54±0.36)mm,治疗后6个月分别为(10.04±2.68)mm Hg、(0.69±0.17)、(3.61±0.46)mm,治疗前,B组的眼压、视力及前房深度分别为(32.81±12.32)mm Hg、(0.16±0.05)、(1.60±0.31)mm,治疗后6个月分别为(11.34±3.42)mm Hg、(0.63±0.15)、(3.67±0.35)mm;治疗后两组各个时段眼压、视力、前房深度均较治疗前明显改善,但组间对比差异无统计学意义(P>0.05);治疗后,A组患者房角出现不同程度开放,未见粘连,B组患者中有5眼房角开放不充分,出现粘连;术后,两组患者均出现角膜水肿,但A组中未见前房出血等其他并发症,B组中由于使用钝性器械分离有3例(23.08%)出现前房少量渗出或出血,组间对比差异有统计学意义(P<0.05)。结论 PHACO联合不同方式GSL均能显著改善PACG合并白内障患者的眼压、视力及前房深度,但联合撕囊前房角粘连分离术治疗效果更佳,能扩大术后房角开放程度,并减少术后并发症。Objective To evaluate the efficacy and safety of phacoemulsification combined with different go-niosynechialysis surgery in treatment of primary angle-closure glaucoma combined with cataract. Methods 30 cases （42 eyes） of PACG combined with cataract were treated in Department of Ophthalmology of our hospital in October 2011 to October 2014,they were randomly divided into 2 groups, 21 patients（29 eyes） of A group were treated by PHACO com-bined with avulsion of goniosynechialysis, 9 patients（13 eyes） of B group were treated by PHACO combined with corti-cal priming of goniosynechialysis.The differences of intraocular pressure, visual acuity, anterior chamber depth, degree of opening of anterior chamber angle and complications were compared between the 2 groups before and after treatment. Results Before treatment,A group of intraocular pressure, visual acuity and anterior chamber depth respectively were （35.74 ±10.56）mmHg, （0.13 ±0.07）, （1.54 ±0.36）mm, after treatment for 6 months were respectively （10.04 ±2.68）, （0.69 ±0.17）, （3.61 ±0.46）mm;Before treatment, B group of intraocular pressure, visual acuity and anterior chamber depth were respectively （32.81±12.32）mmHg,（0.16±0.05）,（1.60±0.31）mm,after treatment for 6 months were respec-tively（11.34±3.42）mmHg,（0.63±0.15）,（3.67±0.35）mm.Compared with before treatment,the intraocular pressure, visual acuity, anterior chamber depth of two groups were significantly improved after treatment, but no significant difference （P〉0.05）;After treatment,A group of patients had different degree of opening of anterior chamber angle,and had no adhe-sion,In the B group, the open angle of 5 eyes were not enough,and had adhesion;After operation, two groups of patients had corneal edema, but there were no other complications in A group,there were 3 cases （23.08%）of B group with a small amount of exudation or bleeding,there were significant differences between two groups （P〈0.05）. Conclusion PHACO combine

关 键 词：原发性闭角型青光眼 白内障 超声乳化白内障吸除术 房角粘连分离术 疗效 

分 类 号：R77[医药卫生—眼科]