超声乳化与小梁切除治疗闭角型青光眼的对比

Comparison of the treatment for acute primary angle-closure glaucoma:phacoemulsification versus trabeculectomy.

目的 对比研究超声乳化人工晶状体植入术与小梁切除术对初次发作的原发性急性闭角型青光眼的疗效。方法 将58例（58眼）初次发作的原发性急性闭角型青光眼合并白内障者随机分为两组，每组29例（29眼），A组行超声乳化吸出人工晶状体植入术，B组行穿透性小梁切除术。术后随访3～6月。结果 术后随访期间两组视力均有提高，以A组提高明显。A组术后前房深度增加；B组术后前房深度减少，并且有5例术后早期发生了浅前房。术后两组眼压均比术前明显降低，早期以B组下降明显，A组有6例术后1天眼压高于21mmHg（1mmHg=0．133kPa），经局部用药后降至正常。结论 初次发作的合并有白内障的原发性急性闭角型青光眼，若无明显前房角粘连，经药物治疗眼压控制不佳者，采用晶状体超声乳化吸出人工晶状体植入术可以有效地降低眼压恢复视功能，且术后并发症较传统的小梁切除术为少。

Objective To compare the effect of phacoemulsification with posterior chamber intraocular lens implantation and trabeculectomy for the treatment of acute primary angle-closure glaucoma. Methods 58 cases（58 eyes） of acute primary angle-closure glaucoma with cataract were randomly divided into 2 groups （29 eyes in each group）, patients in group A received phacoemulsification with posterior chamber intraocular lens implantation, those in group B received trabeculectomy, they were followed up for 3 - 6 months, visual acuity, IOP and anterior chamber depth were recorded to evaluate their clinical effect. Results During the follow-up period, visual acuity improved in beth groups, and it was increased more significantly in group A. Mean of chamber depth was increased in group A and reduced in group B postoperatively. The incidence of shallow anterior chamber in group B was 5/ 29. lOP was reduced significantly in beth groups, and during the early post-operative period, IOP was reduced more significantly in group B. Conclusion Phacoemulsification with posterior chamber intraocular lens implantation can reduce IOP and improve visual acuity effectively with less postoperative complications, it is a good alternative for acute primary angle-closure glaucoma with cataract.