原发性闭角型青光眼伴发白内障的手术探讨

Treatment of angle-closure glaucoma with cataract

目的探讨超声乳化联合人工晶状体植入术治疗原发性闭角型青光眼伴发白内障的临床疗效。方法原发性闭角型青光眼伴发白内障64例（64眼），随机分为临床试验组和对照组各32例。试验组应用超声乳化联合人工晶状体植入术治疗，对照组应用超声乳化联合人工晶状体植入加周边虹膜切除术治疗，观察比较两组患者治疗效果和并发症发生情况。结果治疗前视力及眼压两组对比差异均无统计学意义（P〉0．05）；术后随访6个月，试验组视力≥0．5者占75．00％，眼压为（14．16±1．42）mmHg，对照组视力≥0．5者占46．88％，眼压为（14．27±1．65）mmHg（1mmHg=0．133kPa），试验组视力和眼压的改善情况均明显优于对照组，差异具有统计学意义（P〈0．05）。试验组并发症发生率为9．38％，明显低于对照组的28．13％，两组对比差异有统计学意义（P〈0．05）。结论原发性闭角型青光眼伴发白内障采取超声乳化联合人工晶状体植入术治疗可获得较好的视力效果，并降低并发症发生率，创伤小，安全性高。

Objective To investigate the clinical efficacy of phacoemulsification and intraocular lens implantation in treatment of angle-closure glaucoma with cataract. Methods Sixty-four eyes of 64 cases with primary angle-closure glaucoma with cataract were selected and randomly divided into clinical trial group and the control group （ n = 32） according to the different methods of treatment. Patients in the trial group received phacoemulsification combined intraocular lens （IOL） implantation, the control group underwent phaco emulsification combined artificial lens implantation and peripheral iridectomy treatment. The efficacy and complications of two groups were observed. Results The difference in visual acuity and IOP between before and after surgery were not statistically significant （ P 〉 0.05 ）. Postoperative follow-up of 6 months, the vision ≥0.5 in experimental group were in 75.00%, intraocular pressure were （ 14.16±1.42） mmHg （1 mmHg =0. 133 kPa）, the vision ≥0.5 in control group were in 46.88 %, intraocular pressure were （ 14.27±1.65 ） mmHg. In the trial group the improvement of visual acuity and intraocular pressure were better than those of in the control group, the difference were statistically significant （P 〈 0.05 ）. The complication rate of trial group was 9.38%, it was significantly lower than that of the control group 28.13%, the difference between the two groups was statistically significant. （P 〈 0.05）. Conclusion Phacoemulsification and intraocular lens implantation treated angle-closure glaucoma with cataract can improve the treatment effect, reduce the incidence of complications, it has small trauma and high safety.