超声乳化白内障吸除人工晶状体植入联合小梁切除术治疗闭角型青光眼合并白内障的临床研究

Phacoemulsification and intraocular lens implantation combined with trabeculectomy in the treatment of primary angle-closure glaucoma and cataract

目的观察超声乳化白内障吸除人工晶状体植入联合小梁切除术治疗青光眼合并白内障的临床疗效。方法经临床确诊为青光眼合并白内障的患者40例(40只眼)随机分为对照组与治疗组,每组各20例(20只眼)。对照组单纯行小梁切除术,治疗组行白内障超声乳化人工晶状体植入联合小梁切除术,比较两组治疗前后的只眼压、视力及并发症的发生,术后定期随访半年。结果对照组中17例(17只眼)术后眼压控制在正常范围内,患者手术成功率70.00%;治疗组20例患者中,19例(19只眼)术后眼压控制在正常范围,手术成功率95.00%;两组比较差异显著有统计学意义(P<0.05);治疗组术后视力大于0.5为12例,占60%,对照组术后视力大于0.5为5例,占25%,两组比较差异显著有统计学意义(P<0.05);两组患者术后角膜水肿、前房出血、葡萄膜炎等并发症发生率均较低。结论白内障超声乳化联合小梁切除术治疗青光眼合并白内障在控制眼压、提高视力方面疗效显著,安全性高。

Objective To observe the effects of phacoemulsification and intraocular lens （IOL） implantation com- bined with trabeculectomy in the treatment of primary angle-closure glaucoma and cataract. Methods 40 patients who were diagnosed with angle-closure glaucoma and cataract （40 eyes） were randomly divided into control and treatment group, each having 20 cases 120 eyes ）. Control group was given trabeculectomy only and treatment group was given phaco- emulsification and I0L implantation along with trabeculectomy. Intraocular pressure （ IOP）, visual function, and complica- tions were compared in the 6-month follow-up period. Results In control group, IOP was controlled in normal range in 17 cases （ 17 eyes） after the surgery, and the success rate was 70. 00%. In treatment group, 19 cases （ 19 eyes） showed nor- mal range IOP and the success rate was 95.00%. This difference was statistically significant （ P 〈 0.05 ）. Visual acuity was greater than 0. 5 in 12 cases （ 60% ） in the treatment group and in 5 cases （ 25% ） in control group. The difference was also significant （ P 〈 0. 05 ）. Complications such as corneal edema, anterior chamber bleeding, postoperative uveitis were low in both groups. Conclusions Phacoemulsification and trabeculectomy is effective and safe treatment for the pa- tients with angle-closure glaucoma and cataract.