白内障摘除联合人工晶体植入术治疗闭角型青光眼合并白内障的效果及安全性

Efficacy and safety of cataract extraction and intraocular lens implanta-tion for angle-closure glaucoma combined with cataract

目的探讨白内障摘除联合人工晶体植入术治疗闭角型青光眼合并白内障的效果及安全性。方法将佛山市顺德区桂洲医院2012年2月～2014年3月收治的闭角型青光眼合并白内障患者作为研究对象，共100例，118眼，将纳入患者按奇偶数随机分为对照组和观察组，对照组41例（50眼），观察组59例（68眼）。对照组采用小梁切除术，观察组采用白内障摘除联合人工晶体植入术．术后观察比较两组患者的治疗效果。结果术前两组患者视力情况比较差异无统计学意义（u=0．6526，P〉0．05）；术后1d观察组患者的视力矫正情况明显优于对照组（u=2．1781，P〈0．05）；术后随访调查发现，观察组患者的视力矫正情况明显优于对照组，差异有统计学意义（u=2．1158，P〈0．05）。术前，观察组前房深度及眼内压分别为（1．80±0．39）mm、（25．66±3．27）mmHg，对照组分别为（1．80±0．44）mm、（26．12±5．21）mmHg，两组术前比较差异均无统计学意义（均P〉0．05）；术后，观察组前房深度及眼内压分别为（3．01±0．47）mm、（13．31±4．11）mmHg，对照组分别为（2．91±0．50）mm、（13．12±3．77）mmHg，与术前比较，两组患者前房深度均明显升高，眼内压均明显降低，差异有统计学意义（P〈0．05）。对照组并发症发生率为6．00％，观察组为1．47％，两组并发症发生率比较差异无统计学意义（x^2=1．8050，P〉0．05）。结论白内障摘除联合人工晶体植入术治疗闭角型青光眼合并白内障，安全性较高，患者术后恢复良好，并发症较少，值得临床推广使用。

Objective To investigate the efficacy and safety of cataract extraction and intraocular lens implantation for angle-closure glaucoma combined with cataract. Methods The patients with angle-closure glaucoma combined with cataract admitted to Guizhou Hospital of Shunde District in Foshan City from February 2012 to March 2014 were selected as research objects, a total of 100 cases, 118 eyes, the enrolled patients were randomly divided into control group and observation group according to odd-even number, with 41 cases （50 eyes） in control group, 59 cases （68 eyes） in observation group. The control group was taken trabeculectomy, the observation group was taken cataract extraction and intraocular lens implantation. The curative effect was observed and compared after operation. Results There was no significant difference of vision pre-operation （u = 0.6526, P 〉 0.05）; the vision correction situation of observation group postoperative one day was significantly better than that of control group （u = 2.1781, P 〈 0.05）; postoperative follow-up survey found that, the vision correction situation of observation group was significantly better than that of control group, the difference was statistically significant （u = 2.1158, P 〈 0.05）. Before treatment, the anterior chamber depth and intraocular pressure of observation group was （1.80±0.39） ram, （25.66±3.27） mmHg, which of control group was （1.80±0.44） ram, （26.12±5.21） mmHg, there were no significant differences before operation （ all P 〉 0.05）. After operation, the anterior chamber depth and intraocular pressure of observation group was （3.01±0.47） mm, （13.31±4.11） mmHg, which of control group was （2.91±0.50） mm, （13.12±3.77） mmHg, compared with before operation, the anterior chamber depth of two groups was increased significantly, the intraocular pressure was decreased significantly, the differences were all statistically significant （P 〈 0.05）. The incidence of complications in control group was 6.00%, which of observation group was 1.47%, the difference was not statistically significant （X^2=1.8050, P 〉 0.05）. Conclusion Cataract extraction and intraocular lens implantation for angle-closure glaucoma combined with cataract has high safety. good postoperative recovery, less complications, which is worthy of clinical promotion and application.