自制眼内前房角镜-分离器行前房角分离联合超声乳化白内障吸除及后房型人工晶状体植入术治疗原发性闭角型青光眼的临床研究  

The novel approach of goniosynechialysis combined with cataract phacoemulsification for primary angle-closure glaucoma

作　　者：杨蕾 刘姗姗 范晓军 王一涵 张燕妮 徐嘉轶 王继兵 Yang Lei;Liu Shanshan;Fan Xiaojun;Wang Yihan;Zhang Yanni;Xu Jiayi;Wang Jibing(Binzhou Medical University,Yantai 264000,China;Department of Glaucomatology,Weifang Eye Hospital,Zhengda Guangming Eye Group,National Key Clinical Specialty of Ophthalmology,Weifang 261000,China)

机构地区：[1]滨州医学院,烟台264000 [2]正大光明眼科集团潍坊眼科医院青光眼科国家临床重点专科,261000

出　　处：《中华眼科医学杂志(电子版)》2023年第3期140-145,共6页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

基　　金：山东省医药卫生科技发展计划项目(202207020297)。

摘　　要：目的探讨自制眼内前房角镜-分离器行前房角分离(GSL)联合超声乳化白内障吸除及后房型人工晶状体植入术治疗原发性闭角型青光眼(PACG)的临床疗效。方法选择2021年10月至2022年9月于潍坊眼科医院青光眼科诊断为PACG合并白内障患者45例(60只眼)。其中,男性23例(28只眼),女性22例(32只眼);年龄53~81岁,平均年龄(67.5±14.7)岁。使用随机数字表法将患者分为25例(30只眼)实验组和20例(30只眼)对照组。两组患者均先行超声乳化白内障吸除及后房型人工晶状体植入术,实验组再行自制眼内前房角镜-分离器分离前房角,对照组采用传统恢复器分离。记录两组患者的眼压、房水闪辉计数、最佳矫正视力、中央前房深度、前房角粘连范围(PAS)、角膜内皮细胞密度、青光眼用药数量及并发症的发生情况。PAS范围以眼数和百分比表示,组间比较采用秩和检验。黏弹剂使用剂量、GSL时间、中央前房深度、眼压、最佳矫正视力、房水闪辉计数及角膜内皮细胞密度等符合正态分布,以珋x±s表示,两组组间比较采用独立样本t检验,多个时间点比较采用重复测量方差分析;术后用药数量不符合正态分布,以M(Q1,Q3)表示,组间比较采用Mann-WhitneyU检验。结果实验组患者的GSL手术时间和黏弹剂使用量分别为(1.07±0.77)min和(48.86±11.44)μL;对照组分别为(1.07±0.77)min和(119.07±14.08)μL,比较的差异均有统计学意义(t=-10.00,-21.20;P<0.05)。实验组患者术前、术后1周、1个月、3个月及6个月,眼压分别为(25.30±10.63)mmHg(1mmHg=0.133kPa)、(17.23±3.20)mmHg、(16.80±2.38)mmHg、(16.97±1.87)mmHg及(17.83±2.56)mmHg;中央前房深度分别为(2.31±0.25)mm、(4.38±0.17)mm、(4.36±0.15)mm、(4.33±0.12)mm及(4.26±0.12)mm;房水闪辉计数分别为(13.67±7.26)pc/ms、(28.01±15.72)pc/ms、(15.81±8.30)pc/ms、(12.12±5.32)pc/ms及(10.63±4.47)pc/ms;视力分别为(0.37±0.43)、(0.15±0.27)、(0.14±0.32)�ObjectiveThe aim of this study is to investigate the clinical efficacy of a novel goniosynechialysis(GSL)with cataract phacoemulsification for primary angle-closure glaucoma(PACG).MethodsForty-five patients(60 eyes)diagnosed as PACG complicated with cataract in Department of Glaucomatology of Weifang Eye Hospital from October 2021 to September 2022 were selected.Among them,there were 23 cases(28 eyes)male and 22 cases(32 eyes)female with the mean age of(67.5±14.7)years(ranged from 53 to 81 years).They were divided into experimental group 25 cases(30 eyes)and control group 20 cases(30 eyes)according to the random number table method.They all underwent cataract phacoemulsification,then a novel GSL and a conventional method was used for patients of experimental group and control group,respectively.The range of peripheral anterior synechia(PAS)were recorded before,during and postoperation.The volume of viscoelastic used,GSL time and complications were recorded during operation in the two groups.The number of antiglaucoma medications were recorded,intraocular pressure,the count of aqueous flare,best corrected visual acuity,anterior chamber depth and corneal endothelial cell density were measured before operation and after operation for 1 week,1 month,3 months,6 months.The PAS was counted as the number and percentage of eyes,and used to compare by the rank sum test.The volume of viscoelastic used,GSL time,anterior chamber depth,intraocular pressure,best corrected visual acuity,the count of aqueous flare,corneal endothelial cell density were in accordance with normal distribution,and expressed as±s,and used to compare by the independent samples t test between groups,and used to compare by repeated measures variance analysis at multiple time points.The number of postoperative medications was expressed as M(Q1,Q3),and used to compare by the Mann-Whitney U test between groups.ResultsThe GSL time and the volume of viscoelastic used in the experimental group were(1.07±0.77)min and(48.86±11.44)μL,respectively,while those

关 键 词：眼内前房角镜-分离器 前房角分离 原发性闭角型青光眼 晶状体摘除 

分 类 号：R779.6[医药卫生—眼科]