Phaco联合房角分离术治疗急性闭角型青光眼合并白内障患者的疗效及对视盘血流密度的影响  

Efficacy of Phaco combined with goniosynechialysis in the treatment of acute angle-closure glaucoma with cataract and its effect on visual acuity and optic disc blood flow density

作　　者：何淑艳[1] 王红霞 张迪珂 李燕利 HE Shu-yan;WANG Hong-xia;ZHANG Di-ke;LI Yan-li(Department of Ophthalmology,Affiliated Hospital of Jining Medical University,Jining 272029,Shandong,China)

机构地区：[1]济宁医学院附属医院眼科,山东济宁272029

出　　处：《川北医学院学报》2024年第6期746-750,共5页Journal of North Sichuan Medical College

基　　金：山东省自然科学基金青年项目(ZR2022OH167)。

摘　　要：目的:探讨白内障超声乳化吸出(Phaco)联合房角分离术治疗急性闭角型青光眼(APACG)合并白内障患者的疗效及对视盘血流密度的影响。方法:选取100例APACG合并白内障患者为研究对象,依据手术方式不同分为对照组和观察组,每组各50例。对照组患者实施Phaco+小梁切除术治疗;观察组患者实施Phaco+房角分离术治疗,随访2个月。比较两组患者术后2个月临床疗效;术前、术后7 d、术后1及2个月最佳矫正视力(BCVA);术前及术后2个月眼压、散光度、前房深度及前房角度;术前、术后1 d、术后7 d、1个月及2个月视盘及盘周血流密度;治疗及随访期间并发症发生情况。结果:观察组术后2个月临床总有效率高于对照组(96.00%vs.84.00%,P<0.05)。术后随时间推移,两组患者BCVA均上升(P<0.05),且观察组各时间点均高于对照组(P<0.05)。术后2个月,两组患者眼压均下降(P<0.05),但组间差异无统计学意义(P>0.05);散光度均上升(P<0.05),但观察组低于对照组(P<0.05);前房深度均上升,但组间差异无统计学意义(P>0.05);前房角度均上升(P<0.05),且观察组高于对照组(P<0.05)。术后1 d,两组患者视盘整体血流密度均下降(P<0.05),术后7 d开始上升(P<0.05),术后1个月与术前无统计学差异(P>0.05),术后2个月较术前升高(P<0.05),且术后各时间点观察组均高于对照组(P<0.05)。术前及术后各时间点两组盘周血流密度差异无统计学意义(P>0.05)。观察组总并发症发生率低于对照组(8.00%vs.24.00%,P<0.05)。结论:相较于Phaco+小梁切除术,Phaco联合房角分离术能进一步提升APACG合并白内障患者临床疗效,能更好改善患者术眼散光度及前房角度,提升患者视盘血流密度,且并发症较少。Objective:To investigate the efficacy of phacoemulsification(Phaco)combined with goniosynechialysis in the treatment of acute angle-closure glaucoma(APACG)with cataract and its effect on optic disc blood flow density.Methods:100 patients with APACG complicated with cataract were selected.According to different surgical methods,the patients were divided into control group(n=50)and observation group(n=50).The control group was treated with Phaco+trabeculectomy,and the observation group was treated with Phaco+goniosynechialysis,and followed up for 2 months.2 months after operation,the clinical efficacy of the two groups was compared.The best corrected visual acuity(BCVA)was compared between the two groups before operation,7 days,1 month,and 2 months after operation.The differences of intraocular pressure,astigmatism,anterior chamber depth and anterior chamber angle between the two groups before and 2 months after operation were compared.The optic disc and peripapillary blood flow density of the two groups were measured before operation,1 day,7 days,1 month and 2 months after operation.The complications of the two groups during treatment and follow-up were recorded.Results:The total effective rate of the observation group was higher than that of the control group(96.00%vs.84.00%,P<0.05).With the passage of time,the postoperative BCVA of the two groups increased(P<0.05),and the observation group was higher than the control group at each time point(P<0.05).At 2 months after operation,the intraocular pressure decreased in both groups,and the astigmatism,anterior chamber depth and anterior chamber angle increased in both groups(P<0.05).The astigmatism of the observation group was lower than that of the control group,and the anterior chamber angle was higher than that of the control group(P<0.05).At 1 day after operation,the blood flow density of the optic disc in the two groups decreased compared with that before operation(P<0.05),began to increase at 7 days after operation(P<0.05),was equivalent to that before operation

关 键 词：急性闭角型青光眼 白内障 超声乳化 房角分离术 视盘血流密度 

分 类 号：R775.2[医药卫生—眼科]