内窥镜睫状体光凝术联合白内障超声乳化人工晶状体植入术的临床疗效观察  

Curative Effect of Endoscopic Cyclophotocoagulation Combined with Phacoemulsification and Intraocular Lens Implantation

作　　者：陈雯雯 CHEN Wenwen(People＇s Hospital of Dadukou District,Chongqing 400084,Chin)

机构地区：[1]重庆市大渡口区人民医院眼科,重庆400084

出　　处：《解放军预防医学杂志》2018年第7期937-939,943,共4页Journal of Preventive Medicine of Chinese People's Liberation Army

基　　金：重庆市卫生局2012年医学科研计划项目(No.2012-2-464)

摘　　要：目的观察内窥镜下睫状体光凝术(ECP)联合白内障超声乳化人工晶状体植入术的治疗效果。方法根据不同治疗方法将70例原发性青光眼合并白内障患者分为ECP组与小梁切除组,均行白内障超声乳化人工晶状体植入术,ECP组联合ECP治疗,小梁切除组复合小梁切除术,比较两组手术前后眼压、视力、角膜内皮细胞变化及术后并发症情况。结果两组术后1 d、术后1周、术后1个月、术后3个月眼压比术前均显著下降(P<0.05);ECP组术后1 d、术后1周眼压水平比小梁切除组显著高(P<0.05),而术后1个月、3个月与小梁切除组比较差异无统计学意义(P>0.05);两组术后3个月视力较术前均显著改善(P<0.05),但两组之间比较差异无统计学意义(P>0.05);两组术后3个月角膜内皮细胞计数比术前均显著减少(P<0.05),两组术后3个月角膜内皮细胞计数、变异系数、六棱细胞比例比较差异均无统计学意义(P>0.05);ECP组术后并发症总发生率18.92%,与小梁切除组的27.91%差异无统计学意义(P>0.05)。结论 ECP联合白内障超声乳化人工晶状体植入术能明显降低原发性青光眼合并白内障患者眼压水平,促其视力恢复,且对角膜内皮细胞无明显影响,与复合小梁切除术效果类似。Objective To observe the curative effect of endoscopic cyclophotocoagulation（ ECP） combined with phacoemulsification and intraocular lens implantation. Methods According to treatment methods,70 cases of patients with primary glaucoma and cataract were divided into the ECP group and trabeculectomy group. All these patients were treated with phacoemulsification and intraocular lens implantation,but the ECP group was additionally treated with ECP while the trabeculectomy group was additionally treated with trabeculectomy. The changes of intraocular pressure,visual acuity and corneal endothelial cells before and after surgery and postoperative complications were compared between the two groups. Results 1 day,1 week,1 month and3 months after surgery,the intraocular pressure of the two groups decreased significantly（ P〈0.05）. 1 day and 1 week after surgery,the intraocular pressure of ECP group was significantly higher than that of trabeculectomy group（ P〈0.05）,but there was no significant difference between the two groups 1 month and 3 months after surgery（ P〈0.05）. 3 months after surgery,the visual acuity of the two groups was significantly improved（ P 0. 05）,but there was no significant difference between the two groups（ P〈0.05）. 3 months after surgery,the corneal endothelial cell count in the two groups was significantly lower（ P〉0.05）.3 months after surgery,there was no significant difference between the two groups in the corneal endothelial cell count,variation coefficient or the proportion of six-rowed cells（ P 〉0.05）. The total incidence of postoperative complications showed no significant difference between the two groups（ 18. 92% vs 27. 91%）（ P 〉0. 05）. Conclusion ECP combined with phacoemulsification and intraocular lens implantation can significantly reduce the intraocular pressure of patients with primary glaucomaand cataract,promote the recovery of visual acuity,and has no significant effect on corneal endothelial cells. The effects are similar to those

关 键 词：原发性青光眼合并白内障 内窥镜睫状体光凝术 小梁切除术 

分 类 号：R776.1[医药卫生—眼科] R775.2[医药卫生—临床医学]