难治性青光眼伴白内障应用FLACS和CPCS分别联合引流阀植入术的疗效观察  

Observation on the therapeutic effect of FLACS and CPCS combined with drainage valve implantation in refractory glaucoma with cataract

作　　者：王斌[1] 林介 李园 张志诚 WANG Bin;LIN Jie;LI Yuan(Department of Ophthalmology,The Fourth People's Hospital of Zigong,Zigong Sichuan 643000,China)

机构地区：[1]自贡市第四人民医院眼科,四川自贡643000

出　　处：《临床和实验医学杂志》2024年第19期2065-2069,共5页Journal of Clinical and Experimental Medicine

基　　金：四川省科技计划项目(编号:22ZDYF0380)。

摘　　要：目的探讨难治性青光眼伴白内障应用飞秒激光辅助白内障超声乳化(FLACS)和常规白内障超声乳化(CPCS)联合引流阀植入术的临床疗效。方法回顾性选取2020年1月至2023年4月在自贡市第四人民医院治疗的难治性青光眼伴白内障患者92例,根据最终选取的治疗方案分为FLACS组(n=40)和CPCS组(n=52)。比较两组术前、术后1 d、1周、1个月、3个月和6个月的眼压、最佳矫正视力(BCVA)、角膜内皮细胞密度、中央前房深度等差异,并比较两组术后6个月时手术效果和并发症情况。结果FLACS组和CPCS组术后1 d、1周、1个月、3个月和6个月眼压比较,差异均无统计学意义(P>0.05);FLACS组术后1 d和1周BCVA分别为(0.22±0.09)、(0.20±0.08)LogMAR,优于CPCS组[(0.45±0.10)、(0.38±0.10)LogMAR](P<0.05);FLACS组和CPCS组术后1个月、3个月和6个月BCVA比较,差异均无统计学意义(P>0.05)。FLACS组和CPCS组术后1 d、1周、1个月、3个月和6个月中央前房深度比较,差异均无统计学意义(P>0.05);FLACS组术后1 d、1周、1个月、3个月和6个月角膜内皮细胞密度分别为(2102.32±103.34)、(2088.34±101.21)、(2091.12±100.45)、(2101.43±104.45)和(2095.54±101.44)个/mm^(2),均高于CPCS组[(1720.23±100.20)、(1705.54±98.28)、(1743.34±102.23)、(1802.21±103.32)和(1810.23±102.22)个/mm^(2)],差异均有统计学意义(P<0.05)。FLACS组术后6个月的手术效果优于CPCS组,差异有统计学意义(P<0.05),其完全成功率达到77.50%。FLACS组术后总并发症发生率为15.00%,明显低于CPCS组(34.62%),差异有统计学意义(P<0.05)。结论相较于CPCS,FLACS联合引流阀植入术治疗难治性青光眼伴白内障有较好的临床疗效,值得临床使用。Objective To explore the clinical efficacy of femtosecond laser assisted cataract phacoemulsification(FLACS)and conventional cataract phacoemulsification(CPCS)combined with drainage valve implantation in the treatment of refractory glaucoma with cataract.Methods A total of 92 patients with refractory glaucoma and cataracts treated in The Fourth People's Hospital of Zigong from January 2020 to April 2023 were retrospectively selected and divided into the FLACS group(n=40)and the CPCS group(n=52)based on the final treatment plan.The differences in intraocular pressure,best corrected visual acuity(BCVA),corneal endothelial cell density,and central anterior chamber depth before surgery and 1 day,1 week,1 month,3 months,and 6 months after surgery and so on were compared between the two groups.The surgical results at 6 months after surgery and complications were compared between the two groups.Results There was no statistically significant difference in intraocular pressure between the FLACS group and the CPCS group at 1 day,1 week,1 month,3 months,and 6 months after surgery(P>0.05).The BCVA of the FLACS group at 1 day and 1 week after surgery was(0.22±0.09)and(0.20±0.08)LogMAR,which were better than those of the CPCS group[(0.45±0.1),(0.38±0.10)LogMAR],the differences were statistically significant(P<0.05).There was no statistically significant difference in BCVA between the FLACS group and the CPCS group at 1 month,3 months,and 6 months after surgery(P>0.05).There was no statistically significant difference in central anterior chamber depth between the FLACS group and the CPCS group at 1 day,1 week,1 month,3 months,and 6 months after surgery(P>0.05).The corneal endothelial cell density at 1 day,1 week,1 month,3 months,and 6 months after surgery in the FLACS group was(2102.32±103.34),(2088.34±101.21),(2091.12±100.45),(2101.43±104.45),and(2095.54±101.44)cells/mm^(2),respectively,which was higher than that in the CPCS group[(1720.23±100.20),(1705.54±98.28),(1743.34±102.23),(1802.21±103.32)and(1810.23±102.2

关 键 词：难治性青光眼 白内障 飞秒激光辅助白内障超声乳化 常规白内障超声乳化 引流阀植入术 临床疗效 

分 类 号：R779.6[医药卫生—眼科]