不同术式下治疗原发性闭角型青光眼对患者视力及泪膜的影响

Influence of different surgical treatment for primary angle-closure glaucoma on the patient's vision and tear film

目的 探讨小梁切除术联合超声乳化治疗原发性闭角型青光眼患者的效果.方法 选择2010年1月～2013年1月间在解放军第二○八医院进行治疗的原发性青光眼患者140例,将患者随机分为单纯治疗组及联合治疗组,每组70例（70只眼）,单纯治疗组患者给予单纯小梁切除术,联合治疗组在上述手术的基础上给予超声乳化.术后半年进行相关指标的测定,包括视力,泪膜功能（角膜荧光素染色、ShirmerⅠ试验、泪膜破裂时间）及治愈效果.结果 治疗前,联合治疗组视力、角膜荧光素染色、Shirmer Ⅰ值、泪膜破裂时间分别为（0.50±0.03）、（2.4±0.5）分、（10.4±2.0） mm、（10.1±3.3）s,与单纯治疗组[（0.52±0.02）、（2.5±0.2）分、（10.7±2.1）mm、（10.4±1.8）s]相比,差异无统计学意义（P＞0.05）.经治疗,联合治疗组视力、角膜荧光素染色、Shirmer Ⅰ值、泪膜破裂时间分别为（1.14±0.96）、（1.1±0.0）分、（14.7±2.5） mm、（15.9±2.0）s,较单纯治疗组[（0.62±0.21）、（2.9±0.2）分、（10.5±2.3） mm、（10.7±2.1）s]均改变明显,差异有统计学意义（P＜0.05）.结论 小梁切除术联合超声乳化治疗对于青光眼患者,安全有效,而且术后视力恢复快,泪膜功能恢复较为明显,值得在临床上推广.

Objective To study the influence of trabecular resection combined ultrasonic emulsification operation for the patients with primary angle-closure glaucoma.Methods 140 patients with primary glaucoma from January 2010 to January 2013in the 208th Hospital of PLA were randomly divided into pure treatment group and combined treatment group,each group had 70 cases （70 eyes）,both of the two groups were given simple trabeculectomy,combined treatment group was given ultrasonic emulsification in addition.The relevant indicators were determined after half a year,including the vision,functional （corneal fluorescein staining,Shirmer Ⅰ test,break-up time） and cure effect.Results Before treatment,the vision,corneal fluorescein staining,Shirmer Ⅰ value,break-up time in the combined treatment group were （0.50 ± 0.03）,（2.4 ± 0.5） scores,（10.4 ±2.0） mm,（10.1 ± 3.3） s respectively,compared with the pure treatment group [（0.52 ± 0.02）,（2.5 ± 0.2） scores,（10.7 ± 2.1）mm,（10.4±1.8） s],the differences were statistically significant （P ＜ 0.05）.After treatment,the vision,corneal fluorescein staining,Shirmer Ⅰ value,break-up time in the combined treatment group were （1.14 ± 0.96）,（1.1 ± 0.0） scores,（14.7 ± 2.5）mm,（15.9 ± 2.0） s respectively,compared with the pure treatment group [（0.62 ± 0.21）,（2.9 ± 0.2） scores,（10.5 ± 2.3） mm,（10.7 ± 2.1）s],the differences were statistically significant （P ＜ 0.05）.Conclusion Trabecular resection combined ultrasonic emulsification operation for glaucoma patients,is safe and effective,and quicker visual recovery postoperative,functional recovery of tear film is more obvious,and is worth popularizing in clinic widely.