巩膜瓣联合巩膜隧道切口三联手术治疗青光眼合并白内障疗效分析

Treatment of glaucoma with cataract by scleral flap-scleral tunnel incision triple surgery

目的 探讨巩膜瓣联合巩膜隧道切口三联手术治疗青光眼合并白内障患者的临床效果.方法 将96例青光眼合并白内障患者按随机数字表法分为两组,每组48例.观察组实施巩膜瓣、隧道切口三联手术治疗,对照组实施常规青光眼滤过手术治疗,观察手术全程.检测两组手术前后平均视力、平均眼压的变化,统计治疗过程中两组并发症发生情况.结果 手术后两组视力水平均较手术前显著提高,眼压水平均较手术前显著下降（P〈0.01）;观察组手术后视力水平显著高于对照组,眼压水平显著低于对照组（P〈0.01）.观察组并发症发生率（6.3%）显著低于对照组（18.9%）（χ2=3.69,P〈0.05）.结论 巩膜瓣、巩膜隧道切口三联手术治疗青光眼合并白内障患者效果良好,能显著改善视力,有效降低眼压,安全性高,显著优于单用青光眼滤过手术治疗.

Objective To investigate the clinical effect of scleral flap-scleral tunnel incision triple surgery for the treatment of glaucoma with cataract. Methods 96 patients with cataract and glaucoma were randomly divided into study group and control group. The patients in study group underwent scieral flapscleral tunnel incision triple surgery, and conventional glaucoma filtration surgery was conducted on the patients in control group. The whole operation process was under close observation. The variations of mean eyesight, mean intraocular pressure （IOP） were compared before and after operation, the incidence of complication during the course of treatment was documented. Results After operation, for both group, the eyesight significantly improved, and the IOP significantly decreased （P〈0.01） ; the mean eyesight in study group was significantly better than that in control group, and the mean IOP was significant ly lower than that in control group （P〈0.01）. The incidence of complication in study group （6.3%） was significantly lower than that （18.9%） in control group （x2=3.69, P〈0. 05）. Conclusion Scleral flap- scleral tunnel incision triple surgery can achieve good effect for the treatment of glaucoma and cataract, and can significantly improve eyesight, reduce IOP with high security, is significantly superior to single use of glaucoma filtration surgery.