透明晶状体摘除联合小梁切除术治疗合并短眼轴的原发性闭角型青光眼的初步研究  

Primary Study of Clear Lens Extraction Combined with Trabeculectomy in the Treatment of Primary Angle-closure Glaucoma with Short Axial Length

作　　者：黄煜薇 杨芳 余锦强[1] HUANG Yuwei;YANG Fang;YU Jinqiang(The People’s Hospital of Shiyan City,Hubei Province,Shiyan 442000,China)

机构地区：[1]湖北省十堰市人民医院,湖北十堰442000

出　　处：《中国医学创新》2021年第36期135-140,共6页Medical Innovation of China

摘　　要：目的:观察透明晶状体摘除联合小梁切除术治疗合并短眼轴的原发性闭角型青光眼(primary angle-closure glaucoma,PACG)的临床效果,为合并短眼轴的PACG的治疗提供新思路和理论基础。方法:收集2019年8月-2020年8月十堰市人民医院收治的30例(32眼)晶状体透明且眼轴在19~22 mm范围的PACG患者的临床资料,其中15眼行透明晶状体摘除联合小梁切除术(试验组),17眼行小梁切除术(对照组)。术后随访6个月,观察记录并比较两组患者的裸眼视力、眼压(intraocular pressure,IOP)、最佳矫正视力(best corrected distance visual acuity,BCVA)、前房深度(anterior chamber depth,ACD)、房角开放范围、虹膜-小梁网夹角(trabecular-iris angle,TIA)、平均视野缺损(mean deviation,MD)绝对值、标准视野缺损(pattern standard deviation,PSD)、视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度、术后并发症和手术疗效。结果:两组术前裸眼视力、BCVA、IOP、ACD、房角开放范围、TIA、MD、PSD及各方位RNFL厚度比较,差异均无统计学意义(P>0.05)。术后3、6个月,试验组视力、BCVA均高于对照组,IOP均低于对照组,差异均有统计学意义(P<0.05)。试验组术后ACD、TIA均大于对照组(P<0.05)。两组术后房角开放范围和视野情况比较,差异均无统计学意义(P>0.05)。与术前相比,术后3个月,试验组RNFL仅上、下方变薄,而对照组各方位均发生变薄,差异有统计学意义(P<0.05)。两组术后并发症发生率比较,差异有统计学意义(P<0.05),两组手术疗效比较,差异无统计学意义(P>0.05)。结论:对于合并短眼轴且晶状体透明的原发性闭角型青光眼,透明晶状体摘除联合小梁切除术较小梁切除术有较好且稳定的临床疗效。Objective:To observe the clinical efficacy of clear lens extraction combined with trabeculectomy in the treatment of primary angle-closure glaucoma(PACG)with short axial length,and to provide a new idea and theoretical basis for the treatment of PACG with short axial length.Method:Clinical data were collected from 30 patients(32 eyes)with clear lens and axial length range 19-22 mm of PACG admitted to the People’s Hospital of Shiyan City from August 2019 to August 2020,15 eyes were treated with clear lens extraction combined with trabeculectomy(the experimental group),and 17 eyes were treated with trabeculectomy(the control group).The patients were followed up for 6 months after operation,the uncorrected visual acuity,intraocular pressure(IOP),best corrected visual acuity(BCVA),anterior chamber depth(ACD),atrial angle open range,trabecular-iris angle(TIA),absolute value of mean deviation(MD),pattern standard deviation(PSD),retinal nerve fiber layer(RNFL)thickness,postoperative complications and surgical curative effect were recorded and compared between two groups.Result:There were no significant differences in uncorrected visual acuity,BCVA,IOP,ACD,atrial Angle open range,TIA,MD,PSD,and RNFL thickness between two groups(P>0.05).At 3 and 6 months after operation,the vision and BCVA of the experimental group were higher than those in the control group,and IOP were lower than those in the control group,the differences were statistically significant(P<0.05).The ACD and TIA in the experimental group after operation were higher than those in the control group(P<0.05).There were no statistical differences in postoperative Angle opening range and visual field between two groups(P>0.05).Compared with preoperation,RNFL in the upper and lower parts of the experimental group at 3 months after operation were thinned,while thinning occurred in all parts of the control group,the differences were statistically significant(P<0.05).There was statistical different in the incidence of surgical complications between two groups(P<0.

关 键 词：短眼轴 透明晶状体摘除 小梁切除术 原发性闭角型青光眼 

分 类 号：R779.6[医药卫生—眼科]