飞秒激光辅助超声乳化联合小梁切除术治疗伴发急性闭角型青光眼的白内障  

Efficacy of femtosecond laser assisted phacoemulsification combined with trabeculectomy in the treatment of cataract with acute angle closure glaucoma

作　　者：韦斌 连浩 邓彦 Wei Bin;Lian Hao;Deng Yan(Department of Cataract and Glaucoma,Chengdu Aidi Eye Hospital,Chengdu 610041,China)

机构地区：[1]成都爱迪眼科医院白内障青光眼科,成都610041

出　　处：《中华眼外伤职业眼病杂志》2022年第7期506-512,共7页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评估飞秒激光辅助晶状体超声乳化联合小梁切除术治疗伴发急性闭角型青光眼的白内障的效果。方法回顾性病例对照研究。收集成都爱迪眼科医院2019年9月至2021年9月伴发急性闭角型青光眼的白内障61例(61眼)的临床资料。所有患者根据手术方式分为两组:飞秒激光辅助白内障超声乳化组29例(29眼)为观察组;常规白内障超声乳化组32例(32眼)为对照组。比较两组患者术后视力、眼压、角膜内皮细胞损伤程度、前房深度、手术并发症及治疗成功率。术后随访3个月。结果两组术后视力均较术前提升,眼压均较术前降低(均P<0.05);观察组在术后1 d、1周的视力的改善较对照组显著(t=2.75,2.49;P=0.009,0.012),但在术后1及3个月的视力提高程度差异无统计学意义(t=0.62,0.44;P=1.415,2.021)。对照组在术后随访不同时期的角膜内皮细胞损伤较观察组更明显(P<0.05)。术后不同随访时期两组眼压(F_(时间)=0.25,P_(时间)=0.926;F_(组间)=0.63,P_(组间)=0.423)及前房深度(F_(时间)=0.45,P_(时间)=0.721;F_(组间)=0.85,P_(组间)=0.276)差异无统计学意义。观察组的手术并发症发生率17.24%(5/29)较对照组81.25%(26/32)低(χ^(2)=10.23,P=0.003),但两组的治疗总成功率相近(χ^(2)=0.48,P=0.716)。结论飞秒激光辅助起声乳化联合小梁切除术对伴发急性闭角型青光眼的白内障效果良好,可使患者更早恢复视力。Objective To evaluate the efficacy of femtosecond laser assisted phacoemulsification combined with trabeculectomy in the treatment of cataract with acute angle closure glaucoma.Methods This was a retrospective case control study.The clinical data of 61 eyes of 61 cases of cataract with acute angle closure glaucoma from Sep.2019 to Sep.2021 in Chengdu Aidi Eye Hospital were collected and analyzed.All cases were divided into two groups bases on the different surgical method.Twenty-nine eyes of 29 cases received femtosecond laser assisted phacoemulsification as the observation group and 32 eyes of 32 cases received conventional phacoemulsification as the control group.The visual acuity,intraocular pressure,corneal endothelial cell injury,anterior chamber depth,complication and total success rate after operation were compared between the two groups.The follow-up time was 3 months after surgery.Results The postoperative visual acuity of the two groups all improved and the intraocular pressure was all lower than that before operation(all P<0.05).The improvement of visual acuity in the observation group was more significant than that in the control group at postoperatively 1 day,1 week(t=2.75,2.49;P=0.009,0.012),but there was no significant difference in the improvement degree of visual acuity at 1 month and 3 months after operation(t=0.62,0.44;P=1.415,2.021).The corneal endothelial cell injury in the control group was more obvious than that in the observation group at different stages of postoperative follow-up(P<0.05).There was no significant difference in intraocular pressure(F_(time)=0.25,P_(time)=0.926;F_(groups)=0.63,P_(groups)=0.423)and anterior chamber depth(F_(time)=0.45,P_(time)=0.721;F_(groups)=0.85,P_(groups)=0.276)between the two groups at different stages of postoperative follow-up.The occurrence of surgical complications was 17.24%(5/29)in the observation group,which were lower than the 81.25%(26/32)in the control group(χ^(2)=10.23,P=0.003).However,the total success rate of the two groups was similar(χ^

关 键 词：白内障 青光眼 闭角型 急性 乳化术 晶状体 超声 飞秒激光 小梁切除术 细胞 内皮 角膜 切开术 前囊 

分 类 号：R779.6[医药卫生—眼科]