两种手术方式治疗白内障膨胀期继发性青光眼的效果比较  

Comparison on the efficacy of two kinds of surgery for the treatment of phacomorphic glaucoma

作　　者：裴世林 王素娟 杨潇远[2] 陈鹏[2] 

机构地区：[1]固始县人民医院眼科,河南465200 [2]郑州市第二人民医院眼科,郑州450000

出　　处：《中华眼外伤职业眼病杂志》2017年第9期702-706,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的 比较在晶状体超声乳化人工晶状体植入术的基础上联合小梁切除和联合前房角分离两种手术方式治疗白内障膨胀期继发青光眼的临床效果.方法 回顾性分析白内障膨胀期继发性青光眼手术126例（126眼）,其中行超声乳化人工晶状体植入联合小梁切除术63例（63眼）,行超声乳化人工晶状体植入联合前房角分离术63例（63眼）,随访时间为4～12个月.比较两种手术方式的临床效果及安全性.结果 两组患者术后眼压均较术前明显降低,差异有统计学意义（P〈0.01）;两组患者术后视力比较构成比差异无统计学意义（P〉0.05）;术后两组患者前房深度均较术前增加,差异有统计学意义（P〈0.01）,前房角分离组前房深度增加幅度高于小梁切除组,差异有统计学意义（P〈0.01）;小梁切除组术后炎症反应较重,角膜水肿、浅前房及滤过泡渗漏等并发症发生率明显高于前房角分离组.结论 超声乳化联合小梁切除术和联合前房角分离术均是治疗白内障膨胀期继发青光眼的有效方法,但联合前房角分离术更安全,并发症发生率较低.Objective To compare the efficacy of phacoemulsification intraocular lens implantation combined with trabeculectomy or goniosynechialysis for the treatment of phacomorphic glaucoma.Methods The data of 126 eyes of 126 cases of secondary glaucoma with intumescent cataract were collected and analyzed retrospectively.Group A,63 eyes of 63 patients,underwent phacoemulsification and intraocular lens implantation combined with trabeculectomy;group B,63 eyes of 63 patients,underwent phacoemulicfication and intraocular lens implantation combined with goniosynechialysis.The efficacy and safety between two groups were compared and analyzed.The follow-up period was 4-12 months.Results The postoperative IOP in both groups were well controlled.The difference was statistically significant between before and after surgery（P〈0.01）.The constituent ratio of visual acuity after surgery was not statistically significant between the two groups（P〉0.05）.The central anterior chamber（CAC）after surgery were deeped in two groups.The increase of CAC in group B was higher than that in group A,the difference was statistically significant（P〈0.01）.The complications after surgery were inflammation,corneal edema,shallow anterior chamber and conjunctival bleb leakage.The incidence of complications in group A was significantly higher than that of group B.Conclusion Phacoemulicfication and intraocular lens implantation combined with goniosynechialysis or trabeculectomy for the treatment of phacomorphic glaucoma are effective surgical approach.However,the combined surgery goniosynechialysis is safer and with less complications.

关 键 词：白内障 膨胀期 青光眼 继发性 超声乳化术 前房角分离术 小梁切除术 

分 类 号：R779.6[医药卫生—眼科]