超声乳化吸除联合人工晶状体植入治疗原发性闭角型青光眼合并老年性白内障的临床观察

Clinical observation of phacoemulsification combined with intraocular lens implantation in the treatment of primary angle closure glaucoma complicated with senile cataract

目的:观察单纯白内障超声乳化吸除联合人工晶状体植入术(Phaco+IOL)治疗原发性闭角型青光眼前期合并老年性白内障的临床疗效。方法:采用随机、对照、双盲法将50例原发性闭角型青光眼合并老年性白内障患者分为两组,观察组行单纯Phaco+IOL治疗,对照组行Phaco+IOL联合小梁切除术。对比两组患者术前术后眼压、视力、周边前房深度、房角宽度及并发症情况。结果:Phaco+IOL组和Phaco+IOL联合小梁切除术组患者术后眼压较术前明显降低,前房深度较术前加深,房角宽度较术前加宽或重新开放,视力较术前明显提高(P<0.05)。但两组患者术后前房深度、房角宽度、眼压、视力等指标比较,差异无统计学意义(P>0.05)。两组均未见严重并发症,但Phaco+IOL组并发症发生率较Phaco+IOL联合小梁切除术组低(P<0.05)。结论:白内障超声乳化吸除联合人工晶状体植入术能够有效提高视力,降低眼压,加深前房并开放房角,手术并发症发生率低,是原发性闭角型青光眼临床前期合并老年性白内障一种有效治疗手段。

Objective：To investigate the clinical effects of simple phacoemulsification combined with intraocular lens implantation （ Phaco＋IOL） in the treatment of early primary angle closure glaucoma （ PAGG） complicated with senile cataract.Methods：Fifty cases of PAGG complicated with senile cataract were divided into two groups by a double-blinded randomized controlled method. The study group underwent simple Phaco＋IOL, while the control group underwent Phaco＋IOL plus trabeculectomy. The intraocular pressure （ IOP ） , vision, peripheral anterior chamber depth, anterior chamber angle and complications were compared between the two groups before and after the operation. Results：In the Phaco＋IOL group and Phaco＋IOL plus trabeculectomy group,the IOP decreased significantly, the peripheral anterior chamber depth deepened, the anterior chamber angle widened or reopened,the vision improved significantly after the operation compared with those before the operation （P〈0.05）.The indicators of anterior chamber depth,anterior chamber angle,IOP,and vision did not differ statistically between the two groups after the operation （P〉0.05）.No severe complications were found in the two groups.However,the incidence of complications in the Phaco＋IOL group was lower than that in the Phaco＋IOL plus trabeculectomy group （P〈0.05）.Conclusion：Phaco＋IOL can effectively improve vision,decrease IOP, widen anterior chamber and open anterior chamber angle with low incidence of surgical complications, and therefore is an effective treatment for preclinical PAGG complicated with senile cataract.