闭角型青光眼合并白内障两种术式的临床比较

Clinical comparison of two surgical methods for angle-closure glaucoma combined with cataract

目的探讨不同手术方法治疗慢性闭角型青光眼合并白内障的临床效果。方法54例67眼慢性闭角型青光眼合并白内障患者,随机分为2组,观察组39眼和对照组28眼。观察组行白内障超声乳化吸出人工晶状体植入联合小梁切除术,对照组行单纯白内障超声乳化吸出人工晶状体植入术,术后随访6～12月。结果术后2组早期视力差异无显著性。6月后因眼压较高引起视力下降者,观察组3眼,对照组8眼,2组差异显著(P<0.05);眼压控制在正常范围者(<20.55mmHg,1kPa=7.5mmHg)观察组32眼,对照组20眼。对照组有5眼眼压在30mmHg以上,需手术治疗。2组间有显著性差异(P<0.05)。术后2组并发症的发生无显著差异(P>0.05)。结论慢性闭角型青光眼合并白内障,术前房角粘连≥3/4象限、眼压不易控制者,应选择青光眼白内障联合术,效果更加确切。

Objective To evaluate the clinical effects of treatment for chronic angle-closure glaucoma （ACG） combined with cataract with different surgical methods. Methods Fifty-four patients（67 eyes） with chronic ACG and cataract were divided randomly into observation group（ 39 eyes）and control group （28 eyes）. Observation group accepted phacoemulstftcatton intraocular lens implantation and trabeculectomy, control group accepted phacoemulstftcation and tntraocular lens tmplantaton.All patients followed up 6-12months postoperative. Results There was no marked difference of the postoperative early visual acuity of two groups. Follow 6 months, because of higher IOP, 3 eyes （ observation group） and 8 eyes （control group）complained of decrease of vision. Two groups had significant difference（P（0.05） ;Postoperative IOP （20.55 mmHg in observation group was 32 eyes, control group was 20 eyes, 5 eyes＇ IOP 〉 30 mmHg,which needed surgical treatment.The difference was statistically significant in two groups （P 0.05）. There was no marked difference of complication in two groups after surgery（P 〉0.05）. Conclusion Chronic ACG combined with cataract, preoperative chamber angles closed≥3/4 area, IOP was difficult controlled, should choice the effective surgery of trabecttlectomy combined with cataract extraction and intraocular lens implantation. [Rec Adv Ophthalmol 2005;25（5） ：444-445]