脉络膜上腔引流术联合白内障超声乳化人工晶状体植入术治疗合并白内障的闭角型青光眼  

Efficacy Analysis of Suprachoroidal Drainage Combined with Cataract Phacoemulsification and Intraocular Lens Implantation in the Treatment of Angle Closure Glaucoma Complicated with Cataract

作　　者：韦斌 连浩 邓彦 廖可 WEI Bin;LIAN Hao;DENG Yan;LIAO Ke(Department of Cataract and Glaucoma Ophthalmology,Chengdu Aidi Eye Hospital,Chengdu 610041,Sichuan,China)

机构地区：[1]成都爱迪眼科医院白内障青光眼科,四川成都610041

出　　处：《中国现代手术学杂志》2022年第4期299-303,共5页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨脉络膜上腔引流术联合白内障超声乳化人工晶状体植入术治疗合并白内障的闭角型青光眼的疗效。方法将2018年10月至2020年10月入院的合并白内障的闭角型青光眼患者随机分为观察组52例(52眼)和对照组52例(52眼)。观察组行脉络膜上腔引流术联合白内障超声乳化人工晶状体植入术;对照组行小梁切除术联合白内障超声乳化人工晶状体植入术。比较两组患者术前、术后1周、术后1月和术后3月在提高最佳矫正视力(best corrected visual acuity,BCVA)、降低眼压、加深前房深度(anterior chamber depth,ACD)等方面的效果,比较手术并发症发生率及手术成功率,并观察两种手术方法对角膜内皮细胞损伤程度。结果与术前比较,术后1周、术后1月和术后3月两种术式在BCVA提升、眼压控制、ACD的加深均有明显改善(P<0.05);两组间比较,术后1周、1月和3月BCVA的提高和角膜内皮细胞数量丢失无差异(P>0.05),而眼压及ACD有差异,且观察组优于对照组(P<0.05)。观察组的手术并发症发生率低于对照组(χ2=7.226,P<0.05);手术成功率两组比较无明显差异(χ2=0.484,P>0.05)。结论脉络膜上腔引流术联合白内障超声乳化人工晶体植入术可发挥两种手术的优点,克服对滤过泡引流的依赖,微创操作避免了对眼内组织的侵扰及损害,手术并发症少。Objective To investigate the therapeutic effect of suprachoroidal drainage combined with cataract phacoemulsification and intraocular lens implantation in patients with angle closure glaucoma complicated with cataract.Methods According to the random number,angle closure glaucoma patients with cataract admitted from October 2018 to October 2020 were randomly divided into the observation group(52 cases,52 eyes)and the control group(52 cases,52 eyes).The observation group received suprachoroidal drainage combined with cataract phacoemulsification and intraocular lens implantation.The control group received trabeculectomy combined with cataract phacoemulsification and intraocular lens implantation.The effects of the two groups on improving best corrected visual acuity(BCVA),lowering intraocular pressure,and deepening anterior chamber depth(ACD)were compared preoperatively,and 1-week,1-month,and 3-months postoperatively.Results Compared with that before operation,the BCVA elevation,intraocular pressure control and ACD deepening of the two types of operation at 1 week,1 month and 3 months after operation were significantly improved(P<0.05).Compared between the two groups,there was no difference in the increase of BCVA and the loss of corneal endothelial cells at 1 week,1 month and 3 months after surgery(P>0.05),but there were differences in intraocular pressure and ACD(P<0.05),and the observation group was superior to the control group(P<0.05).The complication rate of the observation group was lower than that of the control group(χ2=7.226,P<0.05),and there was no significant difference between two groups on the success rates(χ2=0.484,P>0.05).Conclusion The suprachoroidal drainage combined with cataract phacoe-mulsification and intraocular lens implantation can play the advantages of the two operations,overcome the dependence on filtering bleb drainage,avoid the invasion and damage of intraocular tissues by minimally invasive operation,and has fewer surgical complications.

关 键 词：脉络膜上腔引流术 超声乳化 人工晶体 小梁切除术 闭角型青光眼 白内障 

分 类 号：R779.6[医药卫生—眼科]