不同手术方式治疗原发性闭角型青光眼合并白内障疗效对比

Comparison of Efficacy of Different Methods of Operation for Primary Angle Closure Glaucoma with Cataract

目的比较不同手术方式治疗原发性闭角型青光眼合并白内障的疗效。方法选取2013年2月至2014年2月南通市通州区第八人民医院收治的原发性闭角型青光眼合并白内障患者92例为研究对象,共98眼,依据随机数字表法分为对照组和观察组,各46例(49眼)。对照组采取单纯小梁切除术,观察组采取小梁切除术联合超声乳化白内障吸除术+人工晶状体植入术。观察对比两组患者的视力、眼压及术后并发症发生情况。结果观察组术后视力、眼压分别为(0.75±0.25)、(10.6±2.1)mm Hg(1 mm Hg=0.133 k Pa),优于对照组的(0.38±0.06)、(15.7±4.2)mm Hg,差异均有统计学意义(P<0.01);观察组总并发症发生率为8.2%(4/49),显著低于对照组的36.7%(18/49),差异有统计学意义(P<0.05)。结论小梁切除术联合超声乳化白内障吸除术+人工晶状体植入术治疗原发性闭角型青光眼合并白内障的临床效果优于单纯小梁切除术,促进患者视力恢复,有效控制眼压,且不良反应少,值得临床推广应用。

Objective To compare the clinical effect of different surgical approaches for treatment of primary angle-closure glaucoma combined with cataract. Methods Total of 92 cases （98 eyes） of primary angle closure glaucoma combined with cataract admitted to Nantong City Tongzhou District Eighth People＇s Hospital from Feb. 2013 to Feb. 2014 were divided into control group and observation group according to random number table method,46 cases （49 eyes） each. The control group received trabeculectomy, and the observation group adopted trabecular resection combined with phacoemulsification ± intraocular lens implanta- tion. the visual acuity,intraocular pressure and postoperative complications of the two groups were observed and compared. Results In the observation group, postoperative visual acuity, intraocular pressure were （0. 75 ± 0. 25 ）, （ 10. 6 ± 2. 1 ） mmHg, better than the control group＇s （0. 38 ± 0. 06）, （ 15.7 ± 4. 2 ） mmHg, the differences were statistically significant（ P 〈 0.01 ） ;complication rate in the observation group was 8.2% （4/49）, significantly lower than the control group＇s 36.7 % （18/49）, the difference was statistically signifi- cant （ P 〈 0. 05 ）. Conclusion The clinical effect of trabecular resection combined with phacoemulsification intraocular lens implantation for primary angle-closure glaucoma with cataract fis better than trabeculecto- my, which can promote visual acuity recovery and effectively control intraocular pressure, with fewer adverse effects, thus is worthy of clinical application.