EX-PRESS青光眼引流器联合超声乳化术治疗POAG合并白内障

EX-PRESS glaucoma drainage device combined with phacoemulsification in treatment of POAG with cataract

目的:观察合并白内障的原发性开角型青光眼患者行超声乳化白内障吸出联合EX-PRESS青光眼引流器植入术的临床效果。方法:选取我院2014-01/2016-02期间收治的原发性开角型青光眼合并白内障患者42例42眼,按照随机数字表法将所有患者随机分为对照组和试验组,其中对照组患者21例21眼,均采用小梁切除联合超声乳化白内障吸出术进行治疗;试验组患者21例21眼,均采用EX-PRESS青光眼引流器联合超声乳化白内障吸出术进行治疗。比较两组患者术后滤过泡、视力、眼压等临床指标及并发症情况。结果:术前两组患者眼压比较无统计学意义(P>0.05),两组患者术后各时间点的眼压情况均显著低于术前,差异有统计学意义(均P<0.05)。术后1d,1、4wk,试验组患者的眼压均显著低于对照组患者,差异有统计学意义(均P<0.05);而术后12wk时,两组患者眼压情况无统计学意义(P>0.05)。试验组患者的手术成功率为95%,显著高于对照组的71%,差异有统计学意义(P<0.05)。术后12wk后两组患者的最佳矫正视力比较无统计学意义(P>0.05);试验组中21眼均表现为功能性滤过泡(Ⅰ、Ⅱ型),而对照组中则有18眼表现为功能性滤过泡。结论:采用EX-PRESS青光眼引流器联合超声乳化白内障吸出术治疗合并白内障的原发性开角型青光眼患者安全可靠,其疗效优于采用小梁切除联合超声乳化白内障吸出术治疗。

AIM： To observe the clinical effect of combined cataract and primary open-angle glaucoma underwent phacoemulsification and glaucoma drainage device implantation.METHODS： We selected in our hospital from January 2014 to February 2016, 42 cases（42 eyes）with primary open-angle glaucoma with cataract. According to random number table method, all of the patients were randomly divided into two groups, control group and study group. In control group, 21 patients（21 eyes）underwent trabecular resection combined phacoemulsification; in study group patients, 21 patients（21 eyes）, underwent EX-PRESS glaucoma drainage device combined phacoemulsification. Compared parameters included postoperative complications and filtering bleb, visual acuity, intraocular pressure（IOP）and other clinical indicators between two groups.RESULTS： Preoperative IOP of two groups was no significantly different（P〉0.05）. Postoperative IOP at each time point was significantly lower than before treatment（P〈0.05）. At 1d, 1 and 4wk after treatment, IOP of the study group was significantly lower than the control group（all P〈0.05）; at 12wk after treatment, IOP of the two groups was not significantly different（P〉0.05）. At 12wk after treatment, surgical success rate of study group was 95%, significantly higher than that of control group 71%（P〈0.05）. The postoperative best corrected visual acuity of two groups was no significantly different（P〉0.05）. At 12wk after treatment, 21 patients in study group were shown as functional filtering bleb, while in the control group 18 cases was functional filtering bleb. CONCLUSION：Using EX-PRESS glaucoma drainage device combined with phacoemulsification in treating cataract with primary open-angle glaucoma is reliable, the curative effect is better than that by trabeculectomy combined with phacoemulsification treatment.