不同切口超声乳化白内障吸除联合小梁切除术的疗效比较

Comparison between one-site and two-site incision in phacotrabeculectomy

目的 比较白内障摘除联合小梁切除术一切口术式和二切口术式的临床疗效。方法按不同术式将 45例 (4 7只眼 )拟行超声乳化白内障吸除人工晶状体植入联合小梁切除术 (联合手术 )患者分为一切口组 2 9只眼和二切口组 18只眼 ,所有病例的晶状体核硬度均不超过Ⅲ级 ,分析比较两组患者的术后眼压控制及并发症情况。随访 13～ 30个月 ,平均 18 9个月。结果 术后平均眼压一切口组为 (16 81± 4 5 6 )mmHg(1mmHg =0 133kPa) ,较术前降低 (15 32± 6 6 7)mmHg ;二切口组为(17 6 3± 4 6 0 )mmHg,较术前降低 (16 42± 6 98)mmHg。两组术后平均眼压下降差异无显著性(t=1 44 ,P >0 0 5 )。结论 联合手术的一切口术式和二切口术式均具有较好的降眼压作用 ;对于软性晶状体核白内障合并青光眼患者 ,两种术式的降低眼压作用基本相同。

Objective To compare the effect of one site and two site incision in phacotrabeculectomy in terms of intraocular pressure control. Methods Forty five cases (47 eyes) of phacotrabeculectomy were retrospectively reviewed. The nuclei of all the cases were not harder than Grade Ⅲ. One site approach was performed on 29 eyes, and two site approach, on 18 eyes. The effects of intraocular pressure control were compared between the two groups. Results Follow up was 13 30 months (mean 18 9 months). The postoperative intraocular pressure in the one site group was (16 81±4 56) mm Hg (1 mm Hg=0 133 kPa), (15 32±6 67) mm Hg lower than that before surgery. And the postoperative intraocular pressure in the two site group was (17 63±4 60) mm Hg, (16 42±6 98) mm Hg lower than that before surgery. There was no significant difference between the two groups relative to the effect of intraocular pressure control ( t =1 44, P >0 05). Conclusion Phacotrabeculectomy, either with one site approach or with two site approach, can provide good intraocular pressure control. The effects are similar between the two approaches in soft cataract patients.