联合手术治疗急性闭角型青光眼伴白内障疗效观察

Observation on the efficacy of combined operation for the treatment of acute angle-closure glaucoma with cataract

目的观察超声乳化联合前房角分离术治疗伴有白内障的急性闭角型青光眼的临床效果。方法2015年11月至2017年2月伴有白内障的急性原发性闭角型青光眼75例(92眼),按随机数字法分为两组,对照组37例(44眼),行超声乳化人工晶状体植入治疗;试验组38例(48眼),在对照组手术基础上联合使用前房角分离术,术后随访观察6个月。结果手术后1、3及6个月,两组患者的眼压、前房深度、视力、视野均明显优于手术前,且试验组术后各时间点的上述指标均优于对照组(均为P<0.05);手术后1、3及6个月,两组患者的前房角分级均明显优于手术前,且试验组术后各时间点前房角分级改善程度均明显优于对照组(P<0.05)。结论对伴有白内障的急性闭角型青光眼使用超声乳化人工晶状体植入联合前房角分离术,不仅能改善前房角深度及开放程度,还能较好地控制眼压,提升患者视力及视野,且手术安全。

Objective To observe the efficacy of phacoemulsification combined with goniosychialysis for the treatment of acute angle closure glaucoma with cataract.Methods The data of 92 eyes of 75 patients with acute primary closure angle glaucoma with cataract from Nov.2015 to 2017 Feb.were collected.All patients were divided into two groups randomly.The control group,44 eyes of 37 cases received phacoemulsification and IOL implantation and the clinical trial group,48 eyes of 38 cases underwent phacoemulsification and IOL implantation combined with goniosychialysis.The followed-up time was 6 months.Results The intraocular pressure,anterior chamber depth,visual acuity and visual field of the two groups were significantly better than those before operation.The changes of the above indexes at the same time after operation in the clinical trial group were significantly better than those in the control group (all P<0.05).Postoperative anterior chamber angle grade of the two groups was significantly better than that before operation.The improvement of angle grade in the clinical trial group was better than that in the control group (P<0.05).Conclusion Phacoemulsification and IOL implantation combined with goniosynechialysis for the treatment of acute primary closure angle glaucoma with cataract is effective and safe.