白内障超声乳化联合内窥镜指导直视下房角分离治疗闭角型青光眼的效果及预后影响因素分析  

Effect of phacoemulsification combined with endoscope-guided phacoemulsification on angle-closure glaucoma and analysis of prognosticfactors

作　　者：魏承丽[1] 禹建羲 岳绍梅 WEI Chengli;YU Jianxi;YUE Shaomei(Xinxiang First People's Hospital,Xinxiang,Henan,453000,China)

机构地区：[1]新乡市第一人民医院眼科,河南新乡453000

出　　处：《实用防盲技术》2025年第1期22-25,F0003,共5页Journal of Practical Preventing Blind

摘　　要：目的探讨白内障超声乳化联合内窥镜指导直视下房角分离治疗闭角型青光眼(angle-closure glaucoma,ACG)的效果及预后影响因素。方法选取急性原发性ACG(primary ACG,PACG)眼患者118例,均行白内障超声乳化联合人工晶体(IOL)植入术,根据房角分离方式的不同将患者随机对照分为观察组(内窥镜直视下用虹膜恢复器进行房角分离)61例和对照组(粘弹剂进行房角分离)57例,比较两组治疗效果,并分析预后影响因素。结果治疗后观察组视力(1.04±0.17vs0.54±0.16)°、前房深度(3.61±0.61vs3.07±0.29)mm、房角宽度(4.08±0.45vs3.07±0.44)°明显高于对照组(t=11.275、21.242、28.319,P<0.05),眼压(18.07±3.56vs29.58±1.31)mmHg、房角镜下周边房角粘连性关闭(primaryangle-closure suspect,PAS)(59.95±19.01vs265.99±30.24)。明显低于对照组,差异均有统计学意义(t=27.942、3.016,P<0.05)。观察组术中前房出血4例,对照组无前房出血。有效73例,经二元Logistic回归分析,年龄≥60岁、晶状体厚度≥5mm是预后的危险因素(P<0.05),内窥镜直视下用虹膜恢复器进行房角分离是预后的保护因素(P<0.05)。结论白内障超声乳化联合内窥镜指导直视下房角分离治疗PACG效果佳;白内障超声乳化联合房角分离治疗PACG患者的预后和年龄、晶状体厚度有关。ObjectiveTo investigate the effect of cataract phacoemulsification combined with endoscope in the treatment of angle-closure glaucoma and the prognostic factors.Methods 118 patients with primary ACG(PACG)were selected,all of whom underwent phacoemulsification combined with intraocular lens(IOL)implantation.According to the different ways of angle separation,the patients were divided into 61 cases in the observation group(angle separation with iris restorer under endoscope)and 57 cases in the control group(angle separation with viscoelastic agent).The therapeutic effects of the two groups were compared,and the prognostic factors were analyzed.Results After treatment,the visual acuity(1.04±0.17 vs 0.54±0.16)°,anterior chamber depth(3.61±0.61 vs 3.07±0.29)mm,and angle width(4.08±0.45vs3.07±0.44)of the observation group were significantly higher than those of the control group(t=11.275、21.242、28.319,P<0.05).The intraocular pressure(18.07±3.56vs29.58±1.31)mmHg and primary angle closure(PAS)(59.95±19.01 vs 265.99±30.24)under angle microscopy were significantly lower than those of the control group,and the differences were statistically significant(t=27.942、3.016,P<0.05).Conclusion Thecombination of phacoemulsification and endoscopic guidancefor the treatment of PACG under direct vision is effective;The prognosis of PACG patients treated with cataract phacoemulsification combined with angle separation is related to age and lens thickness.

关 键 词：白内障超声乳化 内窥镜指导直视下房角分离 闭角型青光眼 

分 类 号：R779.6[医药卫生—眼科]