单双切口超声乳化联合小梁切除术治疗白内障合并PACG临床研究  

Clinical study of single-incision and double-incision phacoemulsification combined with trabeculectomy in the treatment of cataract with PACG

作　　者：余鹏 余飞 舒平 YU Peng;YU Fei;SHU Ping(Department of Ophthalmology,Changshou District People′s Hospital/Changshou Hospital Affiliated to Chongqing Medical University,Chongqing 401220,China)

机构地区：[1]重庆市长寿区人民医院/重庆医科大学附属长寿医院眼科,重庆401220

出　　处：《现代医药卫生》2021年第2期203-206,210,共5页Journal of Modern Medicine & Health

基　　金：重庆市长寿区科学技术局多学科领域临床相关性研究项目(CS2019031)。

摘　　要：目的探讨单、双切口超声乳化联合小梁切除术治疗白内障合并原发性闭角型青光眼(PACG)的临床效果及安全性。方法将2016年1月至2018年12月该院收治的白内障合并PAGG患者63例(74眼)随机分为A、B两组。A组31例(38眼)行单切口超声乳化联合小梁切除术,B组32例(36眼)行双切口超声乳化联合小梁切除术。对比分析术后两组矫正视力,术前及术后1、3、6个月两组眼压、角膜散光、角膜内皮计数。对比分析两组术前及术后3个月前房中央深度(CCT)、中央角膜厚度(ACD)、眼轴长度。结果术后各时间点两组间最佳矫正视力比较,差异均无统计学意义(P>0.05)。术后3个月,两组手术成功率比较,差异无统计学意义(P=0.690)。与术前比较,术后1、3、6个月两组眼压均明显降低,角膜散光度数均增加,但两组间比较,差异均无统计学意义(P>0.05)。术后1、3、6个月两组角膜内皮计数均较术前减少,B组内皮丢失较A组更明显,差异均有统计学意义(P<0.05)。两组术后3个月ACD较术前无变化,CCT及眼轴均优于术前,但两组间比较,差异均无统计学意义(P>0.05)。结论单切口超声乳化联合小梁切除术较双切口联合术术后角膜内皮丢失更少,是更安全、有效的治疗白内障合并PACG的手术方式。Objective To explore the clinical effect and safety of single-incision and double-incision phacoemulsification combined with trabeculectomy in the treatment of cataract complicated with primary angle-closure glaucoma(PACG).Methods 63 patients(74 eyes)with cataract complicated with PACG in the hospital from January 2016 to December 2018 were randomly divided into group A and group B.In group A,31 cases(38 eyes)underwent single-incision phacoemulsification combined with trabeculectomy,and in group B,32 cases(36 eyes)underwent double-incision phacoemulsification combined with trabeculectomy.The corrected vision after operation the intraocular pressure,corneal astigmatism,corneal endothelium count before and 1,3 and 6 months after operation between group A and group B were compared and analyzed.The central anterior chamber depth(ACD),central corneal thickness(CCT)and axial length(AL)before and 3 months after operation between two groups were compared.Results There was no statistically significant difference in the best corrected visual acuity between the two groups at various time points after operation(P>0.05).Three months after operation,there was no statistically significant difference in the surgical success rate between the two groups(P=0.690).Compared with preoperatively,the intraocular pressure and corneal astigmatism increased in the two groups at 1,3,and 6 months after operation,but there was no statistically significant difference between the two groups(P>0.05).Compared with before operation,the corneal endothelium counts of the two groups decreased at 1,3,and 6 months after operation.The endothelial loss of group B was more obvious than that of group A,and the difference was statistically significant(P<0.05).The ACD of the two groups at 3 months after operation did not change compared with that before operation,the CCT and the eye axis were better than before operation,but there was no significant difference between the two groups(P>0.05).Conclusion Single-incision cataract phacoemulsification combined wit

关 键 词：单切口 双切口 白内障超声乳化手术 小梁切除术 联合术式 临床效果 安全性分析 

分 类 号：R246.82[医药卫生—针灸推拿学] R779.66[医药卫生—中医临床基础]