超声乳化白内障吸除联合人工晶体植入术对原发性闭角型青光眼患者视力及眼压的影响研究

Effect of phacoemulsification on visual acuity and intraocular pressure in patients with primary angle closure glaucoma

目的探讨使用超声乳化白内障吸除联合人工晶体植入术对合并白内障的原发闭角型青光眼患者视力及眼压的影响。方法对沈阳市第五人民医院2013年12月—2015年5月间收治的51例合并白内障的原发闭角型青光眼患者进行研究,所有患者均行超声乳化白内障吸除联合人工晶体植入术进行治疗;术前及术后6个月时使用房角镜、超声生物显微镜检查房角及周边粘连关闭等情况;记录术前眼压,并在术后1 d、1周、1个月、3个月及6个月时进行随访,测量记录眼压。结果与治疗前相比,术后6个月时患者最佳矫正视力情况有显著性改善(P<0.05);治疗后各时间点患者眼压均显著低于治疗前(P<0.05);术后6个月时患者房角周边前粘连程度明显优于术前(P<0.05),且差异具有统计学意义。结论采用超声乳化白内障吸除联合人工晶体植入术对合并白内障的原发闭角青光眼患者治疗后,可显著提高患者视力水平,并明显减低患者眼压。

Objective To investigate the effect of phacoemulsification and intraocular lens implantation on visual acuity and intraocular pressure in primary angle closure glaucoma patients with cataract.Methods Fifty-one cases of cataract and primary angle closure glaucoma patients admitted to the fifth people＇hospital of shenyang city between December 2013 and May 2015 were retrospectively studied.All the patients underwent phacoemulsification combined with intraocular lens implant.Before operation and 6 months after treatment,the chamber angle examination and ultrasound biomicroscopy were used to check the adhesion and closure of the chamber angle and peripheral adhesion.The preoperative intraocular pressure was recorded.Follow-up was conducted 1 day,1 week,1 month,3 and 6 months postoperatively and intraocular pressure（IOP） was measured.Results Six months after operation,the peripheral anterior adhesion of the chamber angle in patients was significantly improved（P〈0.05）,and the difference was of statistical significance.The best corrected visual acuity was also improved significantly（P〈0.05） and the intraocular pressure in the patients was significantly（P〈0.05）.The intraocular pressure decreased gradually over time and the difference was of statistical significance（P〈0.05）.Conclusion Phacoemulsification used in the treatment of primary angle closure glaucoma can significantly improve visual acuit y while reducing the int raocular pressure.