超声乳化合并小瞳下房角分离术在白内障合并闭角型青光眼中的应用  

Clinical Application of Phacoemulsification Combined with SubpupilAngle Adhesion Separation in Cataract Complicated withAngle-closure Glaucoma

作　　者：黄翠婷 吴晶晶 吴巧妃 张招德 王雨晴 HUANG Cuiting;WU Jingjing;WU Qiaofei;ZHANG Zhaode;WANG Yuqing(Department of Ophthalmology,the Affiliated Ningde City Hospital of Fujian Medical University,Ningde 352100,China)

机构地区：[1]福建医科大学附属宁德市医院眼科,宁德352100

出　　处：《宁夏医科大学学报》2020年第12期1249-1253,共5页Journal of Ningxia Medical University

基　　金：福建医科大学启航基金(2019QH1307)。

摘　　要：目的研究白内障超声乳化联合小瞳下房角分离术在诊治白内障合并闭角型青光眼的临床效果。方法选择2015年10月至2017年6月收治的86例白内障合并闭角型青光眼患者作为研究对象,随机分为实验组(43例)和对照组(43例),实验组采用超声乳化合并小瞳下房角分离术进行医治,对照组采用白内障超声乳化结合小梁切除术进行医治。比较两组患者在手术前及手术后1 d、1个月、3个月和6个月的眼压及术前及术后1 d、6个月的最佳矫正视力;观察两组患者术前及术后6个月的前房深度、前房角度及并发症的情况。结果两组患者眼压术后1 d、1个月、3个月、6个月均低于术前(P均<0.01),两组患者治疗前后不同时间眼压差异均有统计学意义(P均<0.001);术前两组患者眼压差异无统计学意义(P=0.14);术后1 d及术后1个月眼压实验组均高于对照组(P均<0.05);两组术后3个月和6个月眼压差异无统计学意义(P>0.05);两组患者术前与术后最佳矫正视力差异均有统计学意义(P均<0.001),术后1 d和6个月两组患者最佳矫正视力均高于治疗前(P<0.01);手术前后两组间最佳矫正视力差异均无统计学意义(P均>0.05);两组患者治疗后前房深度均高于治疗前(P<0.001),术前和术后6个月两组间前房深度差异均无统计学意义(P均>0.05);两组患者治疗前、后前房角度差异均有统计学意义(P均<0.001),术后前房角度均较术前提高(P均<0.001);两组间术前前房角度差异无统计学意义(P=0.64);术后6个月实验组患者前房角度大于对照组(P=0.032)。对照组患者并发症发生率(39.53%)高于实验组(13.95%)(P=0.024)。结论采用超声乳化合并小瞳下房角分离术疗效好,安全性高,操作简单创伤小,同时可以明显提高患者视力,降低眼压,增宽房角。Objective To study the clinical effect of phacoemulsification combined with small pupil angle separation in the treatment of cataract with angle closure glaucoma.Methods A total of 86 patients with cataract and angle closure glaucoma from October 2015 to June 2017 were randomly divided into two groups.The experimental group(43 cases)and the control group(43 cases)were treated with phacoemulsification combined with inferior mydriasis angle separation,and the control group with phacoemulsification combined with trabeculectomy.The intraocular pressure,best corrected visual acuity(BCVA)before and 1 d,1 months,3 months and 6 months after operation,anterior chamber depth,anterior chamber angle and complications were compared between the two groups.Results After treatment,intraocular pressure in both groups was lower than that before surgery 1 day,1 month,3 months and 6 months after surgery.There were statistically significant differences in IOP between the two groups at different time points before and after treatment(P all<0.001).There was no significant difference in intraocular pressure between the two groups before surgery(P=0.14).Intraocular pressure was higher in the experimental group 1 day and 1 month after surgery than in the control group(P all<0.05).There was no significant difference in IOP between the two groups at 3 months and 6 months after surgery(P>0.05).There were statistically significant differences in the best corrected visual acuity between the two groups before and after surgery(P<0.001),and the best corrected visual acuity was higher in both groups 1 day and 6 months after surgery than before treatment(P<0.01).There was no statistically significant difference in the best corrected visual acuity between the two groups before and after the operation(P all>0.05).The depth of anterior chamber in both groups was significantly deepened after surgery compared with that before surgery,with statistical significance(P all<0.001).There was no statistically significant difference in the depth of anterior ch

关 键 词：超声乳化 房角分离术 白内障 闭角型青光眼 

分 类 号：R775.2[医药卫生—眼科]