探讨青光眼合并白内障手术方式的选择  

Surgical options for patients with glaucoma and cataract

作　　者：杨翠华[1] 陈玲[1] 陈春霞[1] 

机构地区：[1]安徽省铜陵市人民医院眼科,244000

出　　处：《临床眼科杂志》2018年第1期60-63,共4页Journal of Clinical Ophthalmology

摘　　要：目的探讨青光眼合并白内障的3种手术方式的疗效、并发症及手术选择要点。方法收集我院眼科青光眼合并白内障患者84例(84只眼)为研究对象,分为A、B、C 3组,分别行白内障摘除+小梁切除术、小梁切除术+白内障摘除+人工晶状体植入术、白内障摘除+人工晶状体植入术。分析比较3组病例的术后视力、眼压、并发症及术后住院时间。结果 A、B、C 3组术后视力改善率分别为7.4%、75.9%、96.4%,C组的视力明显优于A组和B组,3组间有显著性差异(P<0.05);3组术后平均眼压分别为(12.67±6.30)mmHg、(10.72±4.37)mmHg、(13.89±3.03)mmHg,与术前比较均有显著性差异(P<0.01);3组均无严重并发症,但C组的并发症明显少于A组和B组;3组的术后住院天数分别为(6.75±2.79)d、(5.52±1.21)d、(2.03±0.58)d,3组间有显著性差异(P=0.00),C组术后住院天数最少。结论青光眼合并白内障的手术方式应根据临床病态发展并结合多种因素而设计,既要能快速降低眼压及保存或提高视力,又要能做到创伤最小;对于早中期青光眼合并白内障患者行白内障摘除联合人工晶状体植入术具有手术损伤小,患者痛苦小,术后恢复快,并发症少,效果显著的特点。Objective To compare the curative effects,complications and indications of the three surgical methods for the treatment of glaucoma and cataract. Methods 84 patients（84 eyes） of glaucoma and cataract in our hospital were enrolled in this study. Patients were divided into three groups and received cataract extraction and trabeculectomy（ group A）,trabeculectomy,cataract extraction and intraocular lens（ IOL） implantation（ group B）,or cataract extraction and IOL implantation. Postoperative visual acuity（ VA）,intraocular pressure（ IOP）,complications and hospitalized duration were analyzed and compared between the groups. Results The rate of VA improvement was 7. 4%,75. 9% and 96. 4% in group A,B and C,respectively. Postoperative VA was significantly better in group C than in other 2 groups. There was significant difference between the 3 groups（ P〈0. 05）. Mean IOP was 12. 67 ± 6. 30,10. 72 ± 4. 37,and 13. 89 ± 3. 03 mmHg in 3 groups and was significantly better than preoperative IOP（ P〈0. 01）. There was no serious complication in all patients. Complication was much less in group C. The duration of hospitalized days was 6. 75 ± 2. 79,5. 52 ± 1. 21,and 2. 03 ± 0. 58 days,respectively. There was significant difference between the 3 groups（ P〈0. 01）,and group C had the least hospitalized days. Conclusions The surgical method for patients with glaucoma and cataract should be designed according to clinical features and many factors. The goal is to quickly reduce IOP and to save or improve VA with minimal trauma. Cataract extraction and IOL implantation for patients with early and middle-stage glaucoma and cataract causes less trauma and pain in patients,and leads to a more rapid recovery,fewer complications. It is worthy of clinical promotion.

关 键 词：青光眼 白内障 手术方式 

分 类 号：R779.6[医药卫生—眼科]