不同手术方式对闭角型青光眼合并白内障的疗效观察

A Clinical Analysis of Different Types of Microsurgery on Primary An-gle-closure Glaucoma with Cataract

目的探讨单纯白内障超声乳化摘除术和青光眼白内障联合手术治疗不同房角关闭状态的闭角型青光眼的效果。方法术前严格选择手术适应证,进行临床对照研究。55例(60眼)闭角型青光眼合并白内障患者分为A组33眼(对照组)和B组27眼(实验组)。对照组行小梁切除联合虹膜周切+白内障超声乳化吸除+晶体囊袋内植入折叠人工晶体术,实验组行白内障超声乳化吸除+晶体囊袋内植入折叠人工晶体术,比较两组治疗前后视力、眼压、前方深度及术后并发症差别,随访时间≥6个月。结果手术后1个月平均眼压A组及B组两组术前及术后比较,差异有统计学意义(P<0.05);两组术前及术后1周视力比较,差异有统计学意义(P<0.05);术后1周两组前方深度比较,差异有统计学意义(P<0.05);两组术后并发症比较,差异无统计学意义(P>0.05)。结论临床治疗闭角型青光眼伴白内障应根据患者不同病情选择适宜的手术治疗方式。

[ ABSTRACT] Objective To investigate the efficacy of glaucoma with cataract phacoemulsification and simple phacoemulsification on different extent of angle-closure glaucoma .Methods The clinical study was researched by the development of surgical indication .Fifty-five patiens（60 eyes） with angle-closure glaucoma and cataract were divided into group A 33 eyes（the control group）,group B 27 eyes（the experimental group）.The control group was taken phacoemusification ,foldable intraocular lens implantation and trabeculectomy ,the experi-mental group was taken phacoemusification and foldable intraocualr lens implantation .The vision,ophthalmotonus ,chamber depth and postop-erative complications before and after operation were compared .All patients were followed up over 6 months.Results At one month after sur-gery,the difference of the mean IOP of group A and group B was statistically significant （P〈0.05）.By international standards,the difference of the corrected visual acuity improved cases in group A and in group B was statistically significant （P〈0.05）before and one week after sur-gery;also,the mean anterior chamber depth preoperatively and postoperatively between two groups was statistically significant （P〈0.05） at one week after surgery.But the difference of postoperative complications between the two groups was not statistically significant （P〈0.05）. Conclusion Treating angle-closure glaucoma and cataract should select suitable operation methods according to patients ＇condition.