两种不同手术方式治疗原发性急性闭角型青光眼合并白内障临床效果对比研究  

Efficacy of two different surgical methods in treatment of primary acute angle-closure glaucoma with cataract

作　　者：张雯[1] 杜兆江 ZHANG Wen;DU Zhaojiang(Department of Ophthalmology,Xi’an Central Hospital,Xi’an 710004,China)

机构地区：[1]西安市中心医院眼科,陕西西安710004

出　　处：《陕西医学杂志》2021年第9期1123-1126,1146,共5页Shaanxi Medical Journal

摘　　要：目的:比较两种不同手术方式对急性闭角型青光眼(PACG)合并白内障的治疗效果及安全性。方法:选择PACG合并白内障患者36例(48眼)为研究对象,根据手术方法不同分为两组。A组(26眼)行白内障超声乳化摘除及人工晶体植入术联合房角分离术。B组(22眼)行白内障超声乳化摘除及人工晶体植入术联合小梁切除术与虹膜周边切除术。术后随访3~12个月,比较两组手术前后视力、眼压及房角情况。结果:两组内手术前后视力比较有统计学差异(均P<0.01),但两组间手术前后视力比较无统计学差异(P>0.05)。与术前比较,两组患者术后1 d、1个月、3个月眼压均显著降低(均P<0.01),但两组间各时间点眼压比较差异无统计学意义(均P>0.05)。两组内手术前后房角关闭范围比较有统计学差异(均P<0.01)。A组术后房角开放情况好于B组(P<0.05)。结论:对于PACG合并白内障患者,两种手术方法均能取得较好的手术效果。白内障手术联合房角分离术在解除瞳孔阻滞的基础上一定程度恢复了前房角功能,操作更简便,手术更安全。Objective:To compare the efficacy and safety of two different surgical methods in the treatment of primary acute angle-closure glaucoma(PACG)with cataract.Methods:36 patients(48 eyes)with PACG and cataract were selected as the research objects,and divided into two groups according to different operation methods.In group A(26 eyes),phacoemulsification and intraocular lens implantation combined with goniosynechialysis was performed.In group B(22 eyes),phacoemulsification and intraocular lens implantation combined with compound trabeculectomy was performed.The patients were followed up for 3 to 12 months,and the visual acuity,intraocular pressure,and anterior chamber angle were compared between the two groups.Results:There was significant difference in visual acuity before and after operation in both groups(all P<0.01),but there was no significant difference in visual acuity before and after operation between the two groups(P>0.05).Compared with preoperative,the intraocular pressure of the two groups was significantly lower at 1 day,1 month and 3 months after operation(all P<0.01),but there was no significant difference at each time point between the two groups(all P>0.05).Anterior chamber angle became wider in Group A than group B(P<0.05).Conclusion:For PACG patients with cataract,two surgical methods can achieve good results.Cataract surgery combined with goniosynechialysis can restore the function of anterior chamber angle to some extent on the basis of relieving pupil block,which is more convenient and safer.

关 键 词：急性闭角型青光眼 白内障 人工晶体植入术 白内障超声乳化摘除术 房角分离术 对比研究 

分 类 号：R775.2[医药卫生—眼科]