基于BCVA和角膜水肿程度探讨改良与常规小梁切除术治疗急性闭角型青光眼的临床价值  

Based on BCVA and modified with conventional corneal edema degree to explore the clinical value of treatment of acute angle-closure glaucoma trabeculectomy

作　　者：李莉[1] 叶青 理珂 方明喜 祁晨顾 LI Li;YE Qing;LI Ke;FANG Mingxi;QI Chengu(Xinyang Aier Eye Hospital,Xinyang 464000,China;Department of Ophthalmology,Suzhou Jiulong Hospital,Suzhou 215300,China;Department of Ophthalmology,Zhengzhou Central Hospital,Zhengzhou 450000,China)

机构地区：[1]信阳爱尔眼科医院青白科,河南信阳464000 [2]苏州九龙医院眼科,江苏苏州215300 [3]郑州市中心医院眼科,河南郑州450000

出　　处：《广州医药》2025年第3期366-371,共6页Guangzhou Medical Journal

基　　金：河南省医学科技攻关联合共建项目(LHGJ20211048)。

摘　　要：目的 基于最佳矫正视力(BCVA)、角膜水肿程度对比改良与常规小梁切除术治疗急性闭角型青光眼(AACG)的疗效。方法 回顾性收集2021年12月—2023年6月期间信阳爱尔眼科医院收治的112例AACG患者作为研究对象,依据1∶1匹配原则,将接受常规小梁切除术的56例患者作为对照组,接受改良小梁切除术的56例患者作为观察组,统计两组围术期BCVA、眼压、术后浅前房形成状况、角膜水肿程度以及并发症状况。结果 术后3个月,观察组视力为(0.63±0.04)logMAR,高于对照组(0.50±0.03)logMAR,眼压为(16.22±2.28)mmHg,低于对照组(19.95±2.31)mmHg(t=19.457、8.600,均P<0.05);观察组浅前房发生率为8.93%,低于对照组的26.79%(χ^(2)=6.087,P=0.014);观察组角膜水肿状况优于对照组(Z=2.737,P=0.006);观察组脉络膜脱离率、滤道阻塞率、前房积血率、虹膜炎症率依次为1.79%、5.36%、16.07%、10.71%,均低于对照组17.86%、23.21%、32.14%、35.71%(χ^(2)=8.166、7.292、3.953、9.818,均P<0.05)。结论 较常规小梁切除术,改良小梁切除术治疗AACG患者,有助于改善视力、降低眼压、减轻角膜水肿、减少浅前房发生,且安全性较高。Objective To compare the efficacy of modified and conventional trabeculectomy in the treatment of acute angle-closure glaucoma(AACG)based on best-corrected visual acuity(BCVA)and degree of corneal edema.Methods A total of 112 patients with AACG admitted to the hospital during December 2021 to June 2023 were retrospectively selected as study objects.According to the 1∶1 matching principle,56 patients receiving conventional trabeculectomy were selected as control group,and 56 patients receiving modified trabeculectomy were selected as observation group.Perioperative BCVA,intraocular pressure,postoperative shallow anterior chamber formation,degree of corneal edema and complications were analyzed.Results At three months postoperatively,visual acuity in the observation group was(0.63±0.04)logMAR,which was higher than that in the control group(0.50±0.03)logMAR,and intraocular pressure was(16.22±2.28)mmHg,which was lower than that in the control group(19.95±2.31)mmHg(t=19.457,8.600,P<0.05);the incidence of shallow anterior chamber in the observation group was 8.93%,which was lower than that of the control group(26.79%)(χ^(2)=6.087,P=0.014);the corneal edema status in the observation group was better than that of the control group(Z=2.737,P=0.006);the rates of choroidal detachment,filtering channel obstruction,hyphema,and iris inflammation in the observation group were 1.79%,5.36%,16.07%,and 10.71%,respectively,which were lower than those of the control group(17.86%,23.21%,32.14%,and 35.71%)(χ^(2)=8.166,7.292,3.953,and 9.818,P<0.05).Conclusions Compared with conventional trabeculectomy,modified trabeculectomy can improve visual acuity,reduce intraocular pressure,relieve corneal edema,and reduce the occurrence of shallow anterior chamber in patients with AACG,with higher safety.

关 键 词：视力 角膜水肿 小梁切除术 急性闭角型青光眼 安全性 

分 类 号：R779.6[医药卫生—眼科]