2种手术方式治疗白内障合并青光眼的比较

Clinical Observation Of Twe Surgical Procedures in the Treatment of Cataract with Glaucoma

目的:比较2种手术方式对白内障合并青光眼病变的治疗效果。方法:将白内障合并青光眼病变患者42例随机分为观察组和对照组,每组各21例。观察组采用超声乳化白内障吸出加人工晶体植入术联合复合式小梁切除术,对照组采用超声乳化白内障吸出加人工晶体植入术联合单纯小梁切除术。随访1年,比较2组术后视力、眼压及并发症的情况。结果:观察组眼压为13.4±3.8 mmHg(1 mmHg=0.133 kPa),对照组眼压为18.9±5.9 mmHg;2组患者手术前后眼压比较均有显著性差异(P<0.05),但观察组眼压降低更显著。观察组患者手术后视力明显提高。对照组脉络膜渗出(出血)13例,虹膜炎症9例,角膜水肿11例,切口漏8例,浅前房9例,功能性滤过泡形成13例;观察组脉络膜渗出(出血)8例,虹膜炎症2例,角膜水肿6例,切口漏2例,浅前房4例,功能性滤过泡形成24例。2组比较,观察组并发症明显少于对照组(P<0.05)。结论:超声乳化白内障吸出加人工晶体植入术联合复合式小梁切除术(三联手术)治疗白内障合并青光眼,控制眼压效果明显,并发症少,临床疗效较好。

Objective：To compare the two surgical methods in the treatment of cataract with glaucoma. Method ：42 patients with cataract and glaucoma were randomly divided into two groups： 21 cases were treated by phacoemulsification, intraocular lens implantation and simple type trabeculectomy in control group ,while 21 cases were treated by phacoemulsification, intraocular lens implantation and combined type trabeculectomy in treatment group. Followed up a year, visual acuity, intraocular pressure and complications were compared with in twe groups after operation on. Results： After treatment, the intraocular pressure in control group was 18.9 ＋ 5.9 mmHg, while in treatment group was 13.4 ＋ 3.8 mmHg. There were the significant differences in intraocular pressure before and after surgery in the two groups, but the treatment group was more significant. The visual acuities were highly raised in the treatment group. In the control group, there were 13 cases of choroidal effusion,9 cases of inflammation of the iris, 11 cases of corneal edema,8 cases of wound drain,9 cases of shallow anterior chamber, 13 cases of functional bleb formation. While in treatment group, there were 8 cases of choroidal effusion,2 cases of inflammation of the iris, 6 cases of corneal edema,2 cases of wound drain ,4 cases of shallow anterior chamber,24 cases of functional bleb formation. The complications were much fewer in the treatment group than in the control group. Conclusions：The phacoemulsification, intraocular lens implantation and combined type trabeculectomy can control intraocular pressure significantly, but have the fewer complications in the treatment of cataract with glaucomar.