激光虹膜周边切开术联合囊袋张力环植入治疗原发性闭角型青光眼伴白内障的远期临床研究  

Long-term clinical observation of laser peripheral iridotomy combined with tension ring implantation in cataract patients with primary angle-closure

作　　者：刘甘甘 荣翱 Liu Gangan;Rong Ao(Cataract Glaucoma Department,Shanghai Xinshijie Eye Hospital,Shanghai 200050,China;Fundus Department,Shanghai Xinshijie Eye Hospital,Shanghai 200050,China;Ophthalmology Department,Tongji Hospital Affiliated to Tongji University,Shanghai 200065,China)

机构地区：[1]上海新视界眼科医院白内障青光眼科,200050 [2]上海新视界眼科医院眼底科,2000502 [3]同济大学附属同济医院眼科,上海2000653

出　　处：《中华眼科医学杂志（电子版）》2024年第4期200-205,共6页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

基　　金：上海申康医院发展中心第一轮促进市级医院临床技能与临床创新三年行动计划项目(16CR3014A)。

摘　　要：目的观察激光虹膜周边切开术(LPI)联合囊袋张力环(CTR)植入对原发性闭角型青光眼(PACG)伴白内障治疗的远期效果。方法收集2019年6—12月期间于上海新视界眼科医院白内障青光眼科就诊的合并PACG老年性白内障患者100例(100只眼)的临床资料。其中,男性52例(52只眼),女性48例(48只眼);年龄54~90岁,平均(71.7±8.3)岁。根据患者术中是否植入CTR将患者分为研究组和对照组。两组患者均行LPI联合白内障手术,研究组术中植入CTR,对照组未植入CTR。比较两组患者术前、LPI术后、白内障术后1d、1个月及4年的视力、眼压、角膜内皮细胞密度及前房深度。性别和眼别等计数资料,以[例(%)]表示,组间比较采用卡方检验。视力、眼压、角膜内皮细胞密度及前房深度等计量资料,符合正态分布的以x珋±s表示,组间比较采用独立样本t检验,组内比较采用配对t检验;不符合正态分布的以M(Q1,Q3)表示,组间比较采用Mann-WhitneyU检验,组内比较采用Wilcoxon符号秩和检验。结果研究组患者54例(54眼)。其中,男性26例(26只眼),女性28例(28只眼);右眼31例(31只眼),左眼23例(23只眼);年龄54~90岁,平均(71.3±8.5)岁;白内障超声乳化手术时间17.00~39.00s,平均(27.76±5.30)s;人工晶状体(IOL)屈光度9.00~30.00D,平均(21.25±4.13)D。对照组患者46例(46只眼)。其中,男性26例(26只眼),女性20例(20只眼);右眼23例(23只眼),左眼23例(23只眼);年龄54~87岁,平均(72.1±8.0)岁;白内障超声乳化手术时间21.00~43.00s,平均(29.72±4.99)s;IOL屈光度10.00~30.00D,平均(21.43±4.20)D。两组性别和眼别分布的比较,差异均无统计学意义(χ^(2)=0.70,0.55;P>0.05);两组年龄和白内障超声乳化手术时间的比较,差异无统计学意义(t=-0.45,-1.89;P>0.05);两组IOL屈光度的比较,差异无统计学意义(Z=-0.052,P>0.05)。研究组和对照组患者白内障术后1d及4年的裸眼远视力分别为0.20(0.10,0.30)最小分辨视角的Objective The aim of this study is to observe the long-term clinical effect of laser peripheral iridotomy(LPI)combined with capsule tension ring(CTR)implantation in cataract patients with primary angle closure glaucoma(PACG).Methods A total of 100 patients(100 eyes)with senile cataract complicated with PACG were retrospectively collected from Cataract Glaucoma Department of Shanghai Xinshijie Eye Hospital from June to December 2019.There were 52 males(52 eyes)and 48 females(48 eyes)with an average age of(71.7±8.3)years(ranged from 54 to 90 years).Patients were divided into study group and control group according to with or without CTR.Both groups of patients underwent LPI combined with cataract surgery,and CTR was implanted in the study group,while not implanted in the control group.The visual acuity,intraocular pressure(IOP),corneal endothelial cell density,and anterior chamber depth of two groups of patients before surgery,after LPI treatment,and after cataract surgery for 1 day,1 month,and 4 years were compared.Gender and ocular data were presented as cases and percentage and used for comparison between groups by chi-square test.Count data such as visual acuity,IOP,corneal endothelial cell count,and anterior chamber depth were described as x±s for data consistent with normal distribution.Independent sample t test was used for inter-group comparison,and paired t test was used for intra-group comparison.Data that did not conform to normal distribution were described by M(Q1,Q3),and used for inter-group comparison by Mann-Whitney U test,and for intra-group comparison was used by Wilcoxon signed rank test.Results There were 54 patients(54 eyes)in the study group.Among them,there were 26 males(26 eyes)and 28 females(28 eyes)with an average of(71.3±8.5)years old(ranged from 54 to 90 years old);there were 31 cases(31 eyes)in the right eye and 23 cases(23 eyes)in the left eye.The phacoemulsification surgery time for cataracts was 17.00 to 39.00 seconds,with an average of(27.765.30)seconds.The refractive error of ar

关 键 词：囊袋张力环 原发性闭角型青光眼 激光虹膜周切术 白内障 人工晶状体 

分 类 号：R779.66[医药卫生—眼科]