两种手术方式治疗急性闭角型青光眼的临床对比观察

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

目的探讨两种不同手术方法治疗急性闭角型青光眼合并白内障的临床效果。方法对86例96只眼急性闭角型青光眼合并白内障患者，凡房角开放1／4象限者，随机分为两组，观察组44只眼，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52只眼行单纯白内障超声乳化吸出＋人工晶状体植入术，术后随访6～10个月。结果术后两组早期视力差异无显著性，6个月后因眼压较高引起视力下降者，观察组5只眼，对照组8只眼，两组间无显著性差异（P〉0．05），眼压控制在正常范围者〈20mmHg（1kPa=7．5mmHg），观察组38只眼，对照组46只眼，两组间无显著性差异（P〉0．05），术后两组并发症的发生无显著差异（P〉0．05）。结论急性闭角型青光眼合并白内障，术前房角粘连个象限以下者，单纯行白内障超声乳化人工晶体植入手术和联合小梁切除术手术效果相当。

Objective To evaluate the clinical effects of treatment for primary acute angle closure glaucoma （PACG）combined with cataract with tow different surgical methods.Methods Eighty-six patients （96 eyes ）with PACG and cataract were divided imrandomly into observation group（44 eyes）and control group （52eyes）.Observation group accepted phacoemulsification intraocular lens implantation and trabeculectomy, control group accepted phacoemulsification and intraocular lens implantation.All patients followed up 6-10months postoperative.Results There was no marked difference of the early postoperative visual acuity between the two groups. Follow 6months, because of higher IOP, 5 eyes（ observation group）and 8 eyes（control group）complained of decrease of vision, the two groups had no significant difference （P〉 0.05 ）;Postoperative IOP 〈20 mmHg in observation group was 38 eyes, control group was 46 eyes, the difference was no statistical- ly significant in two groups （P〉0.05）. There was no marked difference of complication in two groups after surgery（P〉0.05 ）.Conclusion For PACG combined with cataract, and preoperative chamber angles closed 〈 3/4 area,there were no difference between two surgical methods the phacoemulsification intraocular lens implantation and trabeculectomy and the phacoemulsification and intraocular lens implantation.