青光眼合并白内障患者超声乳化人工晶状体植入联合小梁切除术后眼压及房角变化分析

IOP and chamber angle changes after phacoemulsification and intraocular lens implantation combined with trabeculectomy for glaucoma and cataract

目的观察分析青光眼合并白内障患者超声乳化人工晶状体植入联合小梁切除术后眼压及房角变化情况。方法对我院2009年1月至2010年12月青光眼合并白内障患者28例(28眼)进行回顾性分析,所有患者均接受超声乳化人工晶状体植入联合小梁切除术治疗,观察患者术前,术后1d、1周、1个月及3个月眼压变化,A超及前房角镜观察测量术前,术后1个月、3个月中央前房深度及房角变化,对结果进行比较分析。结果患者术后1d、1周、1个月及3个月的平均眼压分别为(19·82±1.21)mmHg(1kPa=7.5mmHg)、(18.64±1.62)mmHg、(16.14±1.36)mmHg、(15.87±0.93)mmHg,与术前(24.35±1.64)mmHg比较,差异均有统计学意义(均为P<0.05)。术后各时间点眼压两两比较,术后1d与术后1周差异无统计学意义(P>0.05),与术后1个月、3个月差异有显著统计学意义(均为P<0.01);术后1周与术后1个月、3个月差异有统计学意义(均为P<0.05);术后1个月与3个月差异无统计学意义(P>0.05)。患者术前、术后1个月、3个月平均中央前房深度分别为(2·0±0.6)mm、(3.1±0.2)mm、(3.2±0.5)mm;与术前中央前房深度相比,术后1个月、3个月差异均有统计学意义(均为P<0·05);术后1个月与3个月比较,差异无统计学意义(P>0.05)。与术前房角开放状态相比,术后1个月、3个月差异均有显著统计学意义(均为P<0.01)。结论超声乳化人工晶状体植入联合小梁切除术治疗青光眼合并白内障患者可有效降低眼压,同时也可明显开放房角,有助于更好地控制眼压。

Objective To investigate the changes of intraocular pressure（IOP） and chamber angle after phacoemulsification and intraocular lens implantation combined with trabeculectomy in patients with glaucoma and cataract.Methods Twenty-eight patients（28 eyes） with glaucoma and cataract from January 2009 to December 2010 in our hospital were retrospectively analyzed,all cases received phacoemulsification and intraocular lens implantation combined with trabeculectomy,the IOP at pre-operation and postoperative 1 day,1 week,1 month and 3 months were observed,the central anterior chamber depth and chamber angle changes were measured and observed by A-ultrasound and gonioscope at pre-operation and postoperative 1 month,3 months,the results were compared and analyzed.Results The mean IOP at postoperative 1 day,1 week,1 month and 3 months were（19.82±1.21）mmHg（1 kPa=7.5 mmHg）,（18.64±1.62）mmHg,（16.14±1.36）mmHg,（15.87±0.93）mmHg,compared with that before operation（24.35±1.64）mmHg,there were statistical differences（all P0.05）;Compared between each two time points,there was no difference between postoperative 1 day and 1 week,1 month and 3 months（P0.05）,statistical differences between postoperative 1 week and 1 month,3 months（all P0.05）,significant differences between postoperative 1 day and 1 month,3 months（all P0.01）.The central anterior chamber depth at pre-operation and postoperative 1 month,3 months were（2.0±0.6）mm,（3.1±0.2）mm,（3.2±0.5）mm,there were statistical differences compared with pre-operation（all P0.05）,but no difference between postoperative 1 month and 3 months（P0.05）.There were significant differences in open and closure of chamber angle at postoperative 1 month and 3 months compared with pre-operation（all P0.01）.Conclusion Phacoemulsification and intraocular lens implantation combined with trabeculectomy for glaucoma and cataract not only decrease the IOP,but open the chamber angle in favor of further control the IOP.