原发性急性闭角型青光眼患者不同术式选择的治疗效果比较  

Comparison on the curative effect of different surgery on patients with acute primary angle-closure glaucoma

作　　者：古丽努尔·买买提[1] 克里木江·阿不拉 阿依努尔·艾买尔[1] Gulinuer·Maimaiti;Kelimujiang·Abula;Ayinuer·Aimaier(Department of Ophthalmology,People′s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院眼科,乌鲁木齐830001

出　　处：《中国眼耳鼻喉科杂志》2020年第6期476-479,共4页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：目的观察原发性急性闭角型青光眼采用不同手术治疗的临床效果。方法105例原发性闭角型青光眼患者,根据治疗方法不同分为A、B、C 3组,A组采用复合式小梁切除术治疗,B组采用复合式小梁切除联合超声乳化白内障吸除+人工晶状体植入术治疗,C组采用超声乳化白内障吸除+人工晶状体植入术治疗。比较3组治疗前后杯盘比(C/D)、视力、眼压及前房深度、眼轴长度改善情况。结果治疗后,C/D面积比显著低于同组治疗前(P<0.05),其中B组C/D面积比低于A组和C组(P<0.05);3组治疗后视力评分均显著高于同组治疗前(P<0.05),其中治疗后B、C组视力评分显著高于A组(P<0.05),B、C组视力评分差异无统计学意义(P>0.05);3组治疗后眼压均显著低于同组治疗前(P<0.05),但治疗后3组间眼压比较,差异无统计学意义(P>0.05);治疗后,3组前房深度(ACD)显著高于同组治疗前(P<0.05),其中B、C组ACD显著高于A组,B组ACD显著高于C组;但治疗后,3组眼轴长度(AL)与同组治疗前相比,差异无统计学意义(P>0.05),组间比较差异亦无统计学意义(P>0.05)。结论3种术式均可有效解决原发性急性闭角型青光眼,其中复合式小梁切除联合超声乳化白内障吸除+人工晶状体植入术可更好加深患者ACD,改善C/D,提高患者视力。Objective To observe the clinical curative effect of different surgery on acute primary angle-closure glaucoma(PACG).Methods According to different treatment methods,105 PACG patients were divided into groups A,B and C.Group A was treated with compound trabeculectomy,group B was treated with compound trabeculectomy,phacoemulsification and intraocular lens(IOL)implantation,and group C was treated with phacoemulsification and IOL implantation.The improvement situations of cup-disc ratio(C/D),visual acuity,intraocular pressure,anterior chamber depth(ACD)and axial length(AL)before and after treatment were compared among the three groups.Results After treatment,area ratios of C/D in the three groups were significantly decreased(P<0.05).The area ratio of C/D in group B was lower than that in group A and C(P<0.05).After treatment,visual acuity scores in the three groups were significantly increased(P<0.05),which were significantly higher in group B and C than group A(P<0.05).There were no significant differences in visual acuity scores between group B and C(P>0.05).After treatment,intraocular pressure in the three groups was significantly decreased(P<0.05),but there was no significant difference in intraocular pressure among the three groups(P>0.05).After treatment,ACD in the three groups was significantly increased(P<0.05).ACD in group B and C was significantly higher than that in group A,and ACD in group B was significantly higher than that in group C.Before and after treatment,there was no significant difference in AL in any group(P>0.05).And the differences among the three groups were not statistically significant(P>0.05).Conclusions All the three kinds of surgical methods can effectively solve acute PACG.The compound trabeculectomy combined with phacoemulsification and intraocular lens implantation can better deepen anterior chamber depth,improve C/D and visual acuity of patients.

关 键 词：原发性急性闭角型青光眼 杯盘比 视力 眼压 手术 

分 类 号：R779.6[医药卫生—眼科]