超声乳化联合前房角分离治疗伴白内障的青光眼

Phacoemulsification combined with goniosynechialysis for glaucoma with cataract

目的:观察晶状体超声乳化联合前房角分离术对伴有白内障的慢性闭角型青光眼患者的治疗效果。方法:无并发症伴有白内障的慢性闭角型青光眼50例50眼,施行晶状体超声乳化吸出人工晶状体植入联合前房角分离术。术后随访3mo,记录并比较术前及术后最佳矫正视力、眼压、前房深度及前房角。备指标均采用均数±标准差(x±s)表示,术前及术后3mo的最佳矫正视力、眼压、前房深度及前房角的情况进行比较。结果:术后3mo的最佳矫正视力较术前明显提高,差异有统计学意义(t=8.76,P=0.001);术后3mo的眼压为15.63±3.11mmHg,较术前(45.12±5.30mmHg)明显下降,差异有统计学意义(t=6.27,P=0.000);术后3mo的前房深度为3.57±0.02mm,较术前(1.43±0.25mm)明显加深,差异有统计学意义(t=8.16,P=0.001);术前、术后前房角情况的比较差异有统计学意义(Z=-4.432,P=0.000;Z=-2.432,P=0.016;Z=-4.379,P=0.000;Z=-4.538,P=0.000)。结论:晶状体超声乳化吸出人工晶状体植入联合前房角分离术治疗伴有白内障的慢性闭角型青光眼,能够有效控制眼压,提高视力,是一种安全、有效的手术方法。

AIM：To observe the clinical efficacy of phacoemulsification combined with goniosynechialysis for chronic angle-closure glaucoma with cataract. METHODS：Fifty eyes in 50 patients with chronic angle-closure glaucoma and cataract, but without complications underwent phacoemulsification and intraocular lens（IOL）implantation, combined with goniosynechialysis. All patients were followed up for 3mo. The best corrected visual acuity（BCVA）, intraocular pressure（IOP）, anterior chamber depth and angle were recorded and compared between pre-operation and post-operation. The results were showed by means plus or subtracting deviation standard. The BCVA, IOP, anterior chamber depth and angle were analysed by t test.RESULTS：The best corrected visual acuity at 3mo after operations was significantly higher than that before operations（t=8.76, P=0.001）. The IOP at 3mo after operations was 15.63±3.11mmHg and was significantly lower than that（45.12±5.30mmHg）before operations（t=6.27, P=0.000）. The anterior chamber depth at 3mo after operations was 3.57±0.02mm, and was significantly deeper than that（1.43±0.25mm）before operations（t=8.16, P=0.001）. Compared with preoperative anterior chamber angle, those after operations were wider（Z=-4.432,P=0.000; Z=-2.432,P=0.016; Z=-4.379,P=0.000; Z=-4.538,P=0.000）. CONCLUSION：Phacoemulsification combined with goniosynechialysis is safe and effective for chronic angle-closure glaucoma with cataract, which can control IOP and improve the visual acuity.