微创前段玻璃体切割治疗白内障合并青光眼的效果观察  

Observation on the effect of minimally invasive anterior vitrectomy in the treatment of cataracts combined with glaucoma

作　　者：李丹 唐丹梅 LI Dan;TANG Danmei(Department of Ophthalmology,Baicheng Central Hospital,Jilin Province,Jilin,Baicheng 137000,China;Department of Ophthalmology,Changchun Yinuo Ophthalmology Hospital,Jilin Province,Jilin,Changchun 130000,China)

机构地区：[1]吉林省白城中心医院眼科,吉林白城137000 [2]吉林省长春一诺眼科医院眼科,吉林长春130000

出　　处：《中国医药科学》2023年第24期168-172,共5页China Medicine And Pharmacy

摘　　要：目的 评价微创前段玻璃体切割联合超声乳化(Phaco)和小梁切除术(TL)治疗白内障合并青光眼的效果和安全性。方法 选取2018年1月至2022年12月吉林省长春市一诺眼科医院收治的白内障合并青光眼患者70例(70眼)进行回顾性分析,根据手术方式不同分为对照组(37例,37眼)和观察组(33例,33眼)。对照组采用Phaco+TL治疗,观察组在对照组基础上联合微创前段玻璃体切割术治疗。评价两组的视力、眼压、并发症情况等,并进行统计比较。结果 与术前相比,两组术后12周时裸眼视力、最佳矫正视力(BCVA)和前房深度明显增加、眼压显著下降,而观察组术后12周裸眼视力、BCVA和前方深度显著大于对照组,眼压显著低于对照组,差异有统计学意义(P <0.05);术前,两组细胞密度、六角形细胞比例、面积的变异系数比较,差异无统计学意义(P> 0.05);术后12周时,观察组细胞密度明显高于对照组、角膜内皮细胞(CECs)丢失率显著低于对照组,差异有统计学意义(P <0.05),两组六角形细胞比例、面积的变异系数比较,差异无统计学意义(P> 0.05);观察组治疗总有效率明显高于对照组,而并发症总发生率显著低于对照组,差异有统计学意义(P <0.05)。结论 在Phaco+TL基础上联合微创前段玻璃体切割术能够有效改善白内障合并青光眼患者的视力和眼压,减少CECs的丢失,提升疗效,降低并发症的发生。Objective To evaluate the efficacy and safety of minimally invasive anterior vitrectomy combined with phacoemulsification(Phaco)and trabeculectomy(TL)in the treatment of cataracts combined with glaucoma.Methods A retrospective analysis was conducted on 70 patients(70 eyes)with cataracts combined with glaucoma admitted to Changchun Yinuo Ophthalmology Hospital,Jilin Province from January 2018 to December 2022.The patients were divided into a control group(37 cases,37 eyes)and an observation group(33 cases,33 eyes)based on different surgical methods.The control group received Phaco+TL,while the observation group received minimally invasive anterior vitrectomy on the basis of Phaco+TL.The visual acuity,intraocular pressure,and complications of the two groups were evaluated,and statistical comparisons were conducted.Results Compared with those before surgery,the naked eye visual acuity,best corrected visual acuity(BCVA),and anterior chamber depth significantly increased,and intraocular pressure significantly decreased in the two groups at 12 weeks after surgery,while the naked eye visual acuity,BCVA,and anterior depth in the observation group were significantly higher than those in the control group at 12 weeks after surgery,and the intraocular pressure was significantly lower than that in the control group(P<0.05).There were no statistically significant differences in the coefficient of variation of cell density,hexagonal cell ratio,and area between the two groups before surgery(P>0.05).At 12 weeks after surgery,the cell density of the observation group was significantly higher than that of the control group,and the loss rate of corneal endothelial cells(CECs)was significantly lower than that of the control group,with statisfically significant differences(P<0.05).There were no statistically significant differences in the coefficient of variation of the proportion and area of hexagonal cells between the two groups(P>0.05).The total effective rate of the observation group was significantly higher than that of the cont

关 键 词：白内障合并青光眼 微创前段玻璃体切割术 超声乳化吸除术 小梁切除术 

分 类 号：R779.6[医药卫生—眼科]