超声乳化人工晶状体植入联合小梁切除术治疗青光眼伴白内障效果及角膜内皮细胞改善价值研究  

Study on the effect of Phacoemulsification and intraocular Lens implantation combined with Trabeculectomy in the treatment of Glaucoma with cataract and the improvement of corneal endothelial cells

作　　者：赵艳[1] ZHAO Yan(The First People's Hospital of Zhengzhou City,Zhengzhou Henan 450000,China)

机构地区：[1]郑州市第一人民医院,河南郑州450000

出　　处：《实用防盲技术》2021年第4期155-158,150,共5页Journal of Practical Preventing Blind

摘　　要：目的探讨青光眼伴白内障患者临床治疗中选用超声乳化人工晶状体植入联合小梁切除术方案的效果及对角膜内皮细胞的影响。方法选取2016年8月至2020年1月进入本院接受诊治的60例青光眼伴白内障患者随机分为两组。对照组(30例,患眼32眼)治疗术式选择小梁切除术,观察组(30例,患眼34眼)术式选择白内障超声乳化人工晶状体植入+小梁切除术。观察患者眼压、视力、前房改善情况及并发症发生情况等。结果观察组术后3个月眼压为(15.50±4.17)mmHg,相比对照组的(18.43±4.28)mmHg更低,差异有统计学意义(t=2.686,P<0.05);观察组术后3个月平均视力为(0.59±0.18),优于对照组的(0.46±0.11),前房深度、角度分别为(3.99±0.27)mm、(38.78±2.78)°,均大于对照组的(3.62±0.26)mm、(28.75±2.64)°,差异有统计学意义(t=3.375、5.407、14.330,均P<0.05);观察组术后1周角膜内皮细胞各项指标(除角膜内皮细胞密度)水平均低于对照组,差异有统计学意义(P<0.05);观察组治疗总有效性为100%(30/30),高于对照组的83.33%(25/30),并发症总发生率为10.00%(3/30),低于对照组的33.33%(10/30),比较差异有统计学意义(x;=5.455、4.812,均P<0.05)。结论青光眼伴白内障患者治疗选用超声乳化人工晶状体植入+小梁切除术方案,可明显提高患者症状改善效果,获得更理想的治疗有效性,且术后并发症更少,安全性理想。Objective To evaluate the efficacy and safety of Phacoemulsification and intraocular Lens implantation combined with Trabeculectomy in the treatment of Glaucoma with cataract.Methods Sixty patients with Glaucoma and cataract who entered our hospital from August 2016 to January 2020 were randomly divided into two groups.The Control Group(30 eyes,32 eyes) was treated with Trabeculectomy,and the Observation Group(30 eyes,34 eyes) was treated with phacoemulsification and intraocular Lens implantation plus trabeculectomy.The IOP,visual acuity,anterior chamber improvement and complications were observed.Results The IOP in the observation group was(15.50±4.17) MMHG 3 months after operation,which was significantly lower than that in the control group(18.43±4.28) mmHg(t=2.686,P <0.05);The average visual acuity of the observation group was(0.59±0.18) months after operation,which was better than that of the Control Group(0.46±0.11).The depth and angle of anterior chamber were(3.99±0.27) mm and(38.78±2.78),respectively,which were higher than that of the Control Group(3.62±0.26) mm and(28.75±2.64),respectively,the differences were statistically significant(t=3.375,5.407,14.330,ALL P<0.05);The level of corneal endothelial cell(except corneal endothelial cell density) in the observation group was lower than that in the control group at 1 week after operation(P<0.05);The total effective rate of the observation group was 100%(30/30),which was higher than that of the control group(83.33%,25/30),and the total complication rate was 10.00%(3/30),which was lower than that of the control group(33.33%,10/30)(χ^(2)=5.455,4.812,ALL P<0.05).Conclusion Phacoemulsification combined with intraocular Lens Implantation and Trabeculectomy for Glaucoma with cataract,the utility model can obviously improve the symptom improvement effect of patients,obtain more ideal treatment effectiveness,and have fewer postoperative complications and ideal safety.

关 键 词：青光眼 白内障 超声乳化人工晶状体植入 小梁切除术 并发症 

分 类 号：R779.6[医药卫生—眼科]