180°小梁切开术治疗原发性开角型青光眼合并白内障的临床疗效与安全性  

The efficacy and safety of 180°trabeculotomy for primary open-angle glaucoma combined with cataract

作　　者：徐智科 王玲 魏欣[1] XU Zhike;WANG Ling;WEI Xin(West China Hospital of Sichuan University,Chengdu 610041,P.R.China;The People’s Hospital of Leshan,Leshan 6140000,P.R.China)

机构地区：[1]四川大学华西医院,成都610041 [2]乐山市人民医院,四川乐山614000

出　　处：《中国循证医学杂志》2024年第7期762-766,共5页Chinese Journal of Evidence-based Medicine

基　　金：乐山市重点研究项目(编号:22SZD063)。

摘　　要：目的比较超声乳化白内障摘除联合房角镜辅助下的180°小梁切开术(gonioscopy-assisted trabeculotomy,GT)与联合复合式小梁切除术(glaucoma filtration surgery,GFS)治疗合并白内障的原发性开角型青光眼的疗效和安全性。方法纳入2021年6月—2022年3月四川省乐山市人民医院眼科中心合并白内障的原发性开角型青光眼患者53例(77只眼)。按手术方式分为GT组和GFS组。术后随访1年,对比两组眼压(intraocular pressure,IOP)、最佳矫正视力(best corrected visual acuity,BCVA)logMAR、使用抗青光眼药物种类、总有效率及并发症情况。结果共纳入GT组27例(43只眼),GFS组26例(34只眼)。两组患者基线情况无统计学差异(P>0.05)。术后1年GT组BCVA logMAR低于GFS组,差异有统计学意义(P<0.01)。GT组较GFS组术后IOP更低,差异有统计学意义(P=0.03)。两组总有效率、使用抗青光眼药物种类和并发症发生率的差异无统计学意义(P>0.05)。结论超声乳化白内障摘除联合GT治疗合并白内障的原发性开角型青光眼安全、有效,具有良好的降压效果。Objective To evaluate the efficacy and safety of phacoemulsification cataract extraction combined with 180°trabeculotomy assisted by gonioscopy(GT)and combined glaucoma filtration surgery(GFS)in the treatment of primary open angle glaucoma(POAG)with cataract.Methods The patients with POAG and cataract in the ophthalmology center of the People’s Hospital of Leshan from June 2021 to March 2022 were included.The patients were divided into GT group and GFS group according to surgical methods.Intraocular pressure(IOP),best corrected visual acuity(BCVA)logMAR,number of anti-glaucoma drugs used,success rate,and complications were compared between the two groups after 1-year followed-up.Results A total of 27 patients(43 eyes)in the GT group and 26 patients(34 eyes)in the GFS group were included.There was no significant difference in baseline between the two groups(P>0.05).BCVA logMAR in the GT group was lower than that in the GFS group at 1 year after surgery,the difference was statistically significant(P<0.01).The postoperative IOP in GT group was lower than that in GFS group,the difference was statistically significant(P<0.05).The difference in total effective rate,the number of anti-glaucoma drugs and the incidence of complications between the two groups were not statistically significant(P>0.05).Conclusion Phacoemulsification cataract extraction combined with GT is safe and effective in the treatment of POAG with cataract and has a good effect on reducing IOP.

关 键 词：原发性开角型青光眼 白内障 小梁切开术 小梁切除术 

分 类 号：R779.6[医药卫生—眼科]