剥脱性青光眼与原发性开角型青光眼行青白联合手术疗效观察  

Clinical observation of combined glaucoma-cataract surgery on pseudoexfoliation glaucoma and primary open angle glaucoma

作　　者：马丽华 李凡 唐广贤 张恒丽 闫晓伟 耿玉磊 Li-Hua Ma;Fan Li;Guang-Xian Tang;Heng-Li Zhang;Xiao-Wei Yan;Yu-Lei Geng(Department of Glaucoma, Shijiazhuang People's Hospital, Shijiazhuang 050000, Hebei Province, China)

机构地区：[1]中国河北省石家庄市人民医院青光眼科,050000

出　　处：《国际眼科杂志》2020年第12期2118-2123,共6页International Eye Science

摘　　要：目的:比较剥脱性青光眼(PXG)与原发性开角型青光眼(POAG)行青光眼白内障联合手术的临床疗效。方法:回顾性选取2015-01/2018-01于我院住院治疗的PXG患者38例40眼作为PXG组,另选取基线资料相匹配的POAG患者36例46眼作为POAG组。观察两组患者行小梁切除+白内障超声乳化摘除+人工晶状体植入术后视力、眼压、抗青光眼药物使用数量及并发症发生情况,并根据标准A(IOP≤21mmHg)、B(IOP≤18mmHg)评定手术疗效,手术完全成功定义为满足上述标准且不进行药物治疗,手术条件成功定义为满足上述标准但需进行药物治疗(≤3种)。结果:术后两组患者视力均较术前改善,眼压均明显降低,抗青光眼药物使用数量均减少。术后1、3mo两组手术完全成功率及条件成功率均无差异(P>0.05)。术后6mo,1、2a,根据标准A,PXG组手术条件成功率(90%、80%、74%)均略低于POAG组(91%、86%、82%,均P>0.05),手术完全成功率(50%、40%、29%)均明显低于POAG组(85%、64%、61%,均P<0.05);根据标准B,PXG组手术条件成功率(70%、70%、59%)略均低于POAG组(80%、80%、75%,均P>0.05),手术完全成功率(45%、30%、18%)均明显低于POAG组(78%、61%、54%,均P<0.05)。结论:PXG及POAG患者实施青光眼白内障联合手术后能够显著提高视力、降低眼压,两者短期手术成功率相似,但PXG患者远期手术成功率明显偏低,且无法达到低标准眼压控制。AIM:To compare effects of combined glaucoma-cataract surgery on pseudoexfoliation glaucoma(PXG)and primary open angle glaucoma(POAG).METHODS:This was a retrospective case-control study conducted the hospitalized patients at department of glaucoma from January 2015 to January 2018.The PXG group included 40 eyes of 38 cases,with 46 eyes of 36 cases on POAG group,which were matched for baseline data.Visual acuity,intraocular pressure(IOP),number of anti-glaucoma medications used and occurrence of complications were observed in both groups after trabeculectomy+phacoemulsification+IOL implantation.Surgical success was defined according to the following 2 criteria:criterion A:IOP≤21mmHg,criterion B:IOP≤18mmHg.Complete success,and qualified success is defined as patients met these criteria with medical treatment(≤3 medications).RESULTS:The visual acuity was improved,with IOP and the number of anti-glaucoma medications used both reduced in both group after surgery.There was no statistically significant difference in complete and qualified success rates between the two groups at 1 and 3mo after surgery(P>0.05).Postoperative 6mo,1 and 2a,for criterion A:the qualified success rates in PXG group(90%,80%,74%)were slightly lower than that of POAG group(91%,86%,82%,P>0.05).The complete success rates in PXG group(50%,40%,29%)were significantly lower than that of POAG group(85%,64%,61%,P<0.05).For criterion B:the qualified success rates in PXG group(70%,70%,59%)were slightly lower than that of POAG group(80%,80%,75%,P>0.05).The complete success rates in PXG group(45%,30%,18%)were significantly lower than that of POAG group(78%,61%,54%,P<0.05).CONCLUSION:The combined glaucoma-cataract surgery in PXG and POAG patients can significantly improve visual acuity and reduce intraocular pressure.The short-term success rates of both types of glaucoma were similar,however the long-term success rates of PXG patients was significantly lower,and it was difficult to achieve a low level IOP.

关 键 词：剥脱性青光眼 原发性开角型青光眼 手术成功率 青光眼白内障联合手术 

分 类 号：R779.6[医药卫生—眼科]