超声乳化人工晶状体植入联合房角分离术在闭角型青光眼合并白内障中的治疗意义

Therapeutic significance of phacoemulsification and intraocular lens implantation combined with angle separation in treating angle closure glaucoma complicating cataract

目的探讨超声乳化人工晶状体植入联合房角分离术在闭角型青光眼合并白内障中的治疗意义。方法选取64例闭角型青光眼合并白内障患者随机分为2组,每组32例。2组均行白内障超声乳化吸除术和人工晶状体植术,研究组联合房角分离术,对照组联合小梁切除术进行手术治疗。对比2组患者临床症状改善情况、视力、眼压、前房深度变化,并对手术并发症的发生率进行随访。结果治疗后2组平均矫正视力、前房深度均较治疗前升高,研究组改善水平显著优于对照组,差异有统计学意义(t=4.40、2.07,P<0.05);2组眼压较治疗前均显著降低,第1、7天2组比较差异有统计学意义(t=11.03、6.92,P<0.05)。第1、3、6个月,2组眼压水平逐渐趋于稳定,组间眼压比较差异无统计学意义(t=1.04、1.18、1.19,P>0.05);对照组并发症发生率高达34.37%,研究组仅有9.37%,差异有统计学意义(P<0.05)。结论超声乳化人工晶状体植入联合房角分离术治疗闭角型青光眼合并白内障是一种安全有效的治疗方案。

Objective To investigate the therapeutic significance of phacoemulsification and intraocular lens implantation combined with angle separation in the treatment of angle closure glaucoma complicated with cataract.Methods Sixty-four patients with angle closure glaucoma complicating cataract were selected and randomly divided into two groups,32 cases in each group.Phacoemulsification and intraocular lens implantation were performed in the two groups.The study group combined with corner separation.The control group combined with trabeculectomy for surgical treatment.with the improvement situation of clinical symptoms,visual acuity,intraocular pressure and anterior chamber depth changes were compared between the two groups.And the incidence of surgical complications was followed up.Results The average corrected visual acuity and anterior chamber depth after treatment in the two groups were elevated compared with before treatment,the improvement level of the study group was significantly better than that of the control group,the difference was statistically significant（t=4.40,2.07,P〈0.05）.IOP after treatment in the two groups was significantly decreased compared with before treatment,which on 1,7dhad statistical difference between the two groups（t=11.03,6.92,P〈0.05）.The IOP level in 1,3,6months was gradually trended to stabilize.There was no statistically significant difference in IOP between the two groups（t=1.04,1.18,1.19,P〉0.05）.The incidence rate of complications in the control group was 34.37%,and which in the study group was only 9.37%,the difference was statistically significant（P〈0.05）.Conclusion Phacoemulsification and intraocular lens implantation combined with trabeculectomy in the treatment of angle closure glaucoma with cataract is a safe and effective treatment scheme.