闭角型青光眼合并白内障的手术治疗分析

Surgical treatment of angle-closure glaucoma and cataract

目的：研究不同手术方式对治疗闭角型青光眼合并白内障的效果分析。方法选择2011年5月至2015年5月我院接诊的100例（100只眼）闭角型青光眼合并白内障患者。随机均分为A、B两组，每组各50例患者。A组采用超声乳化白内障吸除后房型人工晶状体植入术；B组采用小梁切除术。术后进行1～6个月的随访，每2个月做一次记录，比较每组手术前后及组间术后的眼压、矫正实力、中央前房深度、房角的变化。结果 A、B两组患者术后的眼压较术前下降明显，采取超声乳化白内障吸除后房型人工晶状体植入术的患者术后眼压为（10．72±0．35）m m H g ，采取小梁切除术的患者术后眼压为（10．48±0．41） mmHg ，两组患者术后眼压比较差异无统计学意义（P＞0．05）；超声乳化白内障吸除后房型人工晶状体植入术患者术后视力明显比小梁切除术后的患者好，A、B组患者术后视力差异比较有统计学差异（P＜0．05）；A组患者术后的中央前房深度比B组患者术后加深[A 组（3．41±0．02）mm ，B组为（1．93±0．02） mm]，两组患者中央前房深度差异比较有统计学差异（P＜0．05）；A组术后房角开放程度比B组术后开放程度大，两组比较差异有统计学意义（ P＜0．05）。随访3～18个月，A组中有4例患者再次采用小梁切除术控制眼压，B组术后3例患者再次采用小梁切除术控制眼压。结论超声乳化白内障吸除后房型人工晶状体植入术治疗闭角型青光眼合并白内障取得的疗效更为显著。

Objective To study angle‐closure glaucoma combined cataract surgery treatment effect analysis .Methods Chose from May 2011 to May 2015 in our hospital admissions of 100 cases （100 eyes） with angle‐closure glaucoma and cataract patients which were randomly divided into A ,B two groups of 50 patients each .Group A were given phacoemul sification plus intraocular lens implantation .Group B underwent trabeculectomy .The follow‐up time was from 1 months to 6 months ,every 2 months for a record , the preoperative and postoperative intraocular pressure ,corrected visual compared .Results T he postoperative intraocular pressure in group A and B were （10 .72 ± 0 .35 m）mmHg and （10 .72 ± 0 .35） mmHg ,respectively ,which were all lower than pre‐operation ,but there are no statistical difference between two group（P〉0 .05） .The postoperative corrected visual acuity in Group A were better than that in group B there was statistical difference（P〈0 .05） .The postoperative central anterior chamber depth in group A and B were （3 .41 ± 0 .02）mm and （1 .93 ± 0 .02）mm ,respectively ,there was statistical difference （P〈0 .05） . There was statistical difference in open degree of anterior chamber angle between two groups （P〈0 .05） .In group A and B ,re‐trabecular were performed in4 and 3 cases to control intraocular pressure ,respectively . Conclusion For angle‐closure glaucoma and cataract surgical treatment , phacoemul‐sification plus intraocular lens implantation has better effect and deserve to promote .