超声乳化联合小梁切除术对青光眼合并白内障患者视力及并发症的影响

Effect of Phacoemulsification Combined with Trabeculectomy on Visual Acuity and Complications in Patients with Glaucoma and Cataract

目的探讨青光眼合并白内障患者联用超声乳化及小梁切除术的治疗效果.方法选取2020年3月—2022年3月我院收治的86例青光眼合并白内障患者,按随机数字表法分为两组,每组43例.对照组行小梁切除术治疗,观察组加用超声乳化治疗,术后均随访3个月.比较两组患者的视力、眼压水平、图形视觉诱发电位、生活质量及并发症发生情况.结果观察组术后的最佳矫正视力为(0.82±0.12),高于对照组的(0.74±0.11),眼压为(13.36±1.45)mmHg,低于对照组的(15.78±1.59)mmHg,组间差异有统计学意义(P<0.05).观察组术后的高空间频率P100波振幅、低空间频率P100波振幅均高于对照组,高空间频率P100波潜时、低空间频率P100波潜时均短于对照组,组间差异有统计学意义(P<0.05).观察组术后的生理、心理、社会及环境领域评分分别为(81.02±5.86)分、(85.33±5.22)分、(87.78±5.23)分、(88.67±4.38)分,均高于对照组的(74.86±5.72)分、(79.04±5.61)分、(80.47±5.81)分、(82.21±5.41)分,组间差异有统计学意义(P<0.05).两组并发症发生率比较,差异无统计学意义(P>0.05).结论青光眼合并白内障联用超声乳化及小梁切除术效果更佳,可降低眼压水平,促进视力恢复,纠正图形视觉诱发电位异常,改善生活质量,安全可靠.

Objective To investigate the effect of phacoemulsification combined with trabeculectomy in glaucoma with cataract.Methods 86 patients with glaucoma combined with cataract admitted to our hospital from March 2020 to March 2022 were selected and divided into two groups by random number table method,with 43 cases in each group.The control group received trabeculectomy,and the observation group received phacoemulsification combined with trabeculectomy,with a follow-up of 3 months.The two groups'visual acuity,intraocular pressure,graphic visual evoked potential,quality of life and complications were compared.Results After surgery,the observation group's best corrected visual acuity was(0.82±0.12),higher than control group's(0.74±0.11),the intraocular pressure was(13.36±1.45)mmHg,lower than control group's(15.78±1.59)mmHg,the differences between the two groups were statistically significant(P<0.05).After surgery,the observation group's amplitudes of high spatial frequency P100 and low spatial frequency P100 were higher than control group's,and the latent time of high spatial frequency P100 and low spatial frequency P100 were shorter than control group's,the differences between the two groups were statistically significant(P<0.05).After surgery,the observation group's physiological,psychological,social and environmental fields scores were(81.02±5.86)points,(85.33±5.22)points,(87.78±5.23)points and(88.67±4.38)points,respectively,higher than control group's(74.86±5.72)points,(79.04±5.61)points,(80.47±5.81)points and(82.21±5.41)points,and the differences between the groups were statistically significant(P<0.05).There was no significant difference in incidence of complications between the two groups(P>0.05).Conclusion Phacoemulsification combined with trabeculectomy can enhance the therapeutic effect of glaucoma combined with cataract,reduce the intraocular pressure,promote vision recovery,correct the abnormal pattern visual evoked potential,and reduce the influence of the disease on the quality of life.It is safe and reliable.