三种术式治疗急性原发性闭角型青光眼合并白内障的效果观察  

Observation on the Efficacy of Three Surgical Methods in the Treatment of Acute Primary Angleclosure Glaucoma with Cataract

作　　者：周新洪 邓微娜 万阳燕 王卫星 涂雪华 ZHOU Xinhong;DENG Weina;WAN Yangyan;WANG Weixing;TU Xuehua(Cataract Department,Nanchang Bright Eye Hospital,Nanchang 330029,China;不详)

机构地区：[1]南昌普瑞眼科医院白内障科,江西南昌330029

出　　处：《中国医学创新》2024年第19期6-10,共5页Medical Innovation of China

基　　金：江西省卫生健康委普通科技计划项目(20202031)。

摘　　要：目的:对比急性原发性闭角型青光眼(PACG)合并白内障三种术式的效果。方法:筛选2020年2月—2023年2月南昌普瑞眼科医院接受手术治疗急性PACG合并白内障患者96例,按随机数字表法将其分成复合切除组(34例)、小梁切除组(32例)、房角分离组(30例)。比较三组眼科相关参数、并发症与远期生活质量。结果:复合切除组患者的最佳矫正视力(BCVA)、中央前房深度(CAC)、房角开放距离500(AOD500)、小梁虹膜角(TIA)、生活质量评分均高于小梁切除组、房角分离组(P<0.05),眼压(IOP)、房角形态分级、小梁睫状体距离(TCPD)、房角粘连范围(PAS)均低于小梁切除组、房角分离组(P<0.05),三组周边前房深度分级(PAC)、晶状体厚度(TL)、眼轴长度(AL)之间,差异均无统计学意义(P>0.05);小梁切除组、房角分离组BCVA、IOP、CAC、PAC、房角形态分级、TL、AL、AOD500、TIA、TCPD、PAS、生活质量评分比较,差异均无统计学意义(P>0.05)。复合切除组总有效率为94.12%(32/34),高于小梁切除组、房角分离组的71.88%(23/32)、66.67%(20/30),差异均有统计学意义(P<0.05);小梁切除组、房角分离组总有效率比较,差异无统计学意义(P>0.05)。复合切除组并发症发生率为5.88%(2/34),低于小梁切除组、房角分离组的28.13%(9/32)、26.67%(8/30),差异均有统计学意义(P<0.05);小梁切除组、房角分离组并发症发生率之间,差异无统计学意义(P>0.05)。结论:急性PACG合并白内障超声乳化联合复合小梁切除术的效果较显著。Objective:To compare of the therapeutic effects of three surgical methods for acute primary angle-closure glaucoma(PACG)with cataract.Method:A total of 96 patients with acute PACG with cataract who underwent surgical treatment in Nanchang Bright Eye Hospital from February 2020 to February 2023 were selected,and were divided into three groups by random number table method,compound resection group(34 cases),trabeculectomy group(32 cases),and angle separation group(30 cases).Three groups of ophthalmic related parameters,complications,and long-term quality of life were compared.Result:The best corrected visual acuity(BCVA),central anterior chamber depth(CAC),angle open distance 500(AOD500),trabecular iris angle(TIA),quality of life score of patients in the compound resection group were higher than those in the trabeculectomy group and angle separation group(P<0.05);while intraocular pressure(IOP),angle morphology grading,trabecular ciliary processes distance(TCPD)and peripheral anterior synechia(PAS)were lower than those in the trabeculectomy group and angle separation group,the differences were statistically significant(P<0.05);there were no statistically significant differences in peripheral anterior chamber depth grading(PAC),lens thickness(TL),and axial length(AL)among the three groups(P>0.05).There were no statistically significant differences in BCVA,IOP,CAC,PAC,angle morphology grading,TL,AL,AOD500,TIA,TCPD,PAS,and quality of life scores among the trabeculectomy group and angle separation group patients(P>0.05).The total effective rate of patients in the compound resection group was 94.12%(32/34),which was higher than 71.88%(23/32)in the trabeculectomy group and 66.67%(20/30)in the angle separation group,the differences were statistically significant(P<0.05);there was no statistically significant difference in the total effective rate between the trabeculectomy group and angle separation group(P>0.05).The incidence of complications in the compound resection group was 5.88%(2/34),which was lower than 28.13%(9/3

关 键 词：白内障 急性原发性闭角型青光眼 超声乳化 房角分离术 小梁切除术 复合小梁切除术 

分 类 号：R779.6[医药卫生—眼科]