超声乳化吸除术联合虹膜周边切除术与联合小梁切除术治疗闭角型青光眼合并白内障的临床疗效比较  

Comparison of Clinical Effects of Phacoemulsification Combined with Peri-Iris Resection and Combined with Trabeculectomy in Treatment of Angle-closure Glaucoma with Cataract

作　　者：吴琳艳[1] 王凯[1] 范茂利 WU Linyan;WANG Kai;FAN Maoli(Department of Ophthalmology,Fuyang Fifth People′s Hospital,Fuyang 236000,China)

机构地区：[1]阜阳市第五人民医院眼科,安徽阜阳236000

出　　处：《医学综述》2021年第14期2909-2912,F0003,共5页Medical Recapitulate

摘　　要：目的比较超声乳化吸除术联合虹膜周边切除术与联合小梁切除术治疗闭角型青光眼(ACG)合并白内障的临床疗效。方法选取2019年3月至2020年3月阜阳市第五人民医院眼科收治的ACG合并白内障患者68例(80眼)为研究对象,根据手术方法不同分为小梁组和虹膜组,其中虹膜组42眼,主要行超声乳化吸除术联合虹膜周边切除术;小梁组38眼,行超声乳化吸除术联合小梁切除术治疗。术后所有患者随访3个月,比较两种术式对患者视力、眼压、周边与中央前房深度、眼轴长度/晶状体厚度比值的影响,以及手术成功率和并发症发生率。结果两组患者术后1周、1个月、3个月视力>0.5的眼数比例比较差异无统计学意义(P>0.05)。术后3个月,两组眼压低于术前,小梁组患者眼压控制效果优于虹膜组(P<0.01)。与术前比较,术后两组中央前房深度明显增加(P<0.05),晶状体厚度/眼轴长度系数显著降低(P<0.05)。虹膜组患眼手术成功率为97.62%(41/42),小梁组成功率为94.74%(36/38),两组比较差异无统计学意义(P>0.05)。虹膜组患眼手术总并发症发生率低于小梁组[26.19%(11/42)比55.26%(21/38)](P<0.05)。结论超声乳化吸除术联合虹膜周边切除术与联合小梁切除术均是治疗ACG合并白内障患者安全有效的术式,其中小梁组控制眼压的效果显著优于虹膜组,但小梁组患者术后并发症较多。Objective To compare the clinical efficacy of phacoemulsification combined with peripheral iris resection and combined with trabeculectomy in the treatment of angle-closure glaucoma(ACG)combined with cataract.Methods A total of 68 patients(80 eyes)with ACG complicated with cataract admitted to Department of Ophthalmology,Fuyang Fifth People′s Hospital from Mar.2019 to Mar.2020 were included.The patients were divided into an iris group and a trabeculae group were divided according to different surgical methods.Among them,42 eyes of the iris group were mainly treated by phacoemulsification combined with peri-iris resection,while 38 eyes in the trabecular group were treated with phacoemulsification and trabeculectomy.All patients were followed up for 3 months after operation,and the effects of the two surgical methods on visual acuity,intraocular pressure,peripheral and central anterior chamber depth,axial length/lens thickness ratio,and the rate of surgical success and complications were observed and compared.Results There was no statistically significant difference in the proportion of eyes with>0.5 at 1 week,1 month and 3 months after surgery between two groups(P>0.05).Three months after operation,the intraocular pressure in both groups was lower than that before operation,and the control effect of intraocular pressure in the trabecular group was better than that in the iris group(P<0.01).After operation,the depth of central anterior chamber of both groups was significantly increased(P<0.05),while the lens thickness/axial length coefficient was significantly decreased(P<0.05).The success rate of the iris group was 97.62%(41/42),of the trabecular group was 94.74%(36/38),and there was no significant difference between the two groups(P>0.05).The incidence of surgical complications in the iris group was lower than that in the trabecular group[26.19%(11/42)vs 55.26%(21/38)](P<0.05).Conclusion Phacoemulsification combined with peri-iris resection and combined with trabeculectomy are both safe and effective treatments

关 键 词：闭角型青光眼 白内障 超声乳化吸除术 虹膜周边切除术 小梁切除术 手术效果 

分 类 号：R775.2[医药卫生—眼科]