白内障超声乳化对闭角型青光眼并发白内障患者视力恢复的效果分析

Effect Analysis of Restoring Eyesight Using Phacoemulsification in Patients with Angle-closure Glaucoma with Cataract

目的探讨白内障超声乳化(CP)技术对闭角型青光眼并发白内障(ACGWC)患者视力恢复的临床疗效。方法选取2012年3月至2013年3月十堰市中医医院眼科收治的ACGWC患者86例(86眼),依据随机数字表法分为观察组和对照组,每组43例(43眼)。对照组进行小梁切除术治疗,观察组进行CP联合后房型人工晶状体植入方式治疗。对比两组患者视力恢复、眼压及中央前房深度变化和术后并发症等情况。结果两组患者治疗后视力均有所恢复,且观察组病患视力恢复情况显著优于对照组;治疗后,观察组患者眼压显著低于治疗前和对照组[(16±10)mm Hg(1 mm Hg=0.133 k Pa)比(28±11)mm Hg、(24±10)mm Hg],中央前房深度显著深于治疗前和对照组[(3.12±0.10)mm比(1.92±0.10)mm、(2.79±0.08)mm],差异均有统计学意义(均P<0.01)。观察组轻度角膜水肿发生率为18.2%(8/43),高于对照组的9.1%(4/43),差异有统计学意义(P<0.05);观察组浅前房发生率为0%,低于对照组的9.1%(4/43),差异有统计学意义(P<0.05)。结论 CP联合人工晶状体植入,有利于ACGWC患者视力恢复,并能加深中央前房深度,降低眼压,为ACGWC的新型有效疗法。

Objective To analyze the effect of eyesight restoring using cataract phacoemulsification （CP） in the treatment of patient with angle closure glaucoma with cataract（ACGWC）. Methods Total of 86 patients（86 eyes） with ACGWC admitted to Shiyan Hospital of Traditional Chinese Medicine from Mar. 2012 to Mar. 2013 were included,and they were divided into observation group and control group according to random number table method,43 cases （43 eyes） each. The control group was given trabeculectomy for treatment, while the observation group was given CP combined with intraocular lens implantation. The central visual acuity, intraocular pressure, anterior chamber depth change, and the postoperative complications of the two groups were compared. Results Visual acuity recovered at different degrees after treatment in both groups, and the observation group was better than the control group ; after treatment,intraocular pressure of the observation group was lower than before treatment and the control group [ （16 ±10） mmHg vs （28±11 ） mmHg, （24±10） mmHg], and central anterior chamber depth was deeper than before treatment and the control group [ （3.12±0. 10） mm vs （1.92±0. 10） mm, （2.79±0. 08） mini ,the differences were statistically significant（ all P 〈 0.01 ）. The occurrence of mild corneal edema rate of the observation group was higher than the control group [ 18.2% （8/43） vs 9. 1% （4/43） ] ,the difference was statistically significant（P 〈 0.05 ） ;shallow anterior chamber occurrence of the observation group was lower than the control group [ 0% vs 9. 1% （4/43） ], the difference was statistically significant （P 〈 0. 05 ）. Conclusion CP combined with intraocular lens implantation is beneficial to ACGWC patients＇ eyesight recovery and can deepen the anterior chamber depth, reduce intraocular pressure, thus is a new effective therapy for ACGWC.