超声乳化联合房角分离术治疗闭角型青光眼合并白内障疗效及房角结构变化的影响  

Effectiveness of Phacoemulsification Combined with Goniosynechialysis in the Treatment of Angle-Closure Glaucoma with Cataract and its Impact on Anterior Chamber Angle Structures

作　　者：张晓鸣[1] 吴志航 徐雷 Zhang Xiaoming;Wu Zhihang;Xu Lei(Ophthalmology,Kunshan Hospital of Traditional Chinese Medicine,Kunshan,Jiangsu,512300,China)

机构地区：[1]江苏省昆山市中医医院眼科,江苏昆山215300

出　　处：《黑龙江医学》2024年第23期2819-2822,共4页Heilongjiang Medical Journal

基　　金：江苏省自然科学基金项目(BK20205870)。

摘　　要：目的:探讨超声乳化联合房角分离术在闭角型青光眼合并白内障治疗中的效果及房角结构变化的影响。方法:选取2018年1月—2023年1月江苏省昆山市中医医院眼科收治的62例闭角型青光眼患者作为研究对象,按照治疗方案不同分为对照组(n=31,接受小梁切除术联合超声乳化)和研究组(n=31,接受房角分离术联合超声乳化)。持续观察3个月,比较两组患者临床治疗有效率,手术前后患者眼压、散光度及最佳矫正视力、房角结构(中央前房深度、小梁虹膜角、房角开放距离、小梁睫状突距离)、房角开放状态及并发症发生率。结果:研究组治疗有效率高于对照组,差异有统计学意义(χ^(2)=6.269,P<0.05);术后3个月,研究组散光度低于对照组,差异有统计学意义(t=8.266,P<0.05);术后1个月,研究组中央前房深度、小梁虹膜角、房角开放距离高于对照组,差异均有统计学意义(t=2.767、6.885、3.819,P<0.05);术后1个月、3个月,两组患者窄房角Ⅲ~Ⅳ级降低至Ⅰ~Ⅱ级,且研究组宽房角开放状态高于对照组,差异均有统计学意义(χ^(2)=6.941、8.098,P<0.05);观察组并发症发生率低于对照组,差异有统计学意义(χ^(2)=5.833,P<0.05)。结论:超声乳化结合房角分离术治疗闭角型青光眼合并白内障具有安全性和有效性,可显著改善闭角型青光眼合并白内障患者的散光度和房角结构,降低并发症发生风险。Objective:To explore the effectiveness and impact on the angle structure of the combination of phacoemulsification and goniosynechialysis in the treatment of angle-closure glaucoma with concurrent cataract.Methods:Selecting 62 cases of closed-angle glaucoma treated in the Ophthalmology Department of Kunshan Traditional Chinese Medicine Hospital in Jiangsu Province from January 2018 to January 2023 as the research sample.They were divided into two groups according to different treatment plans:the control group(n=31,receiving trabeculectomy+phacoemulsification),and the study group(n=31,receiving iridotomy+cataract phacoemulsification).The patients were observed for three months.The clinical effectiveness,preoperative and postoperative intraocular pressure(IOP),astigmatism,best corrected visual acuity,and anterior chamber angle structure(central anterior chamber depth,trabecular-iris angle,angle opening distance,and trabecular ciliary process distance),angle opening status,and complication rates were compared between the groups.Results:The clinical treatment effectiveness was higher in the study group than in the control group(χ^(2)=6.269,P<0.05).Three months after operation,diffuser of the study group was lower than the control group,and the difference was statistically significant(t=8.266,P<0.05).1 month after surgery,the central anterior chamber depth,trabecular iris angle,and opening distance of chamber angle in the study group were higher than those in the control group,with statistically significant difference(t=2.767,6.885,3.819;P<0.05).1 month and 3 months after surgery,narrow chamber Angle gradesⅢ~Ⅳdecreased toⅠ~Ⅱin 2 groups,and the wide chamber angle opening in the study group was higher than that in the control group.The difference was statistically significant(χ^(2)=6.941,8.098;P<0.05).The complication rate of the observation group was lower than that of the control group,and the difference was statistically significant(χ^(2)=5.833,P<0.05).Conclusion:Phacoemulsification combined with goniosyne

关 键 词：超声乳化 房角分离术 闭角青光眼 白内障 房角结构 

分 类 号：R775[医药卫生—眼科]