小梁切除术联合玻璃体抽吸术对急性闭角型青光眼持续高眼压状态患者术后视力恢复及生活质量的影响

Effects of trabeculectomy combined with vitreous aspiration on postoperative visual acuity and quality of life in acute angle closure glaucoma with persistent high intraocular pressure patients

目的 探讨小梁切除术联合玻璃体抽吸术对急性闭角型青光眼持续高眼压状态患者术后视力恢复及生活质量的影响。方法 82例急性闭角型青光眼持续高眼压状态患者依据手术方案分为对照组和治疗组，每组41例（41眼）。对照组实施前房穿刺术＋小梁切除术治疗，治疗组实施小梁切除术＋玻璃体抽吸术治疗。统计两组手术效果、功能性滤过泡形成及并发症情况，并对比手术前后两组眼压、视力水平及生活质量评分。结果 两组手术效果比较，治疗组总有效率[97.56%（40/41）]高于对照组[78.05%（32/41）]，差异有统计学意义（P〈0.05）；两组术前眼压、视力水平及生活质量评分比较，差异未见统计学意义（P〉0.05）；治疗组术后眼压低于对照组，视力水平、躯体功能、物质功能、社会功能及心理功能评分均高于对照组，差异有统计学意义（P〈0.05）；两组功能性滤过泡形成率比较，治疗组[92.68%（38/41）]高于对照组[75.61%（31/41）]，差异有统计学意义（P〈0.05）；两组并发症发生率比较，治疗组[9.76%（4/41）]低于对照组[56.84%（11/41）]，差异有统计学意义（P〈0.05）。结论 小梁切除术与玻璃体抽吸术联合治疗急性闭角型青光眼持续高眼压状态，效果显著，可降低患者眼压，促进视力恢复及功能性滤过泡形成，且安全性高，可有效改善患者生活质量。

Objective To investigate the effect of trabeculectomy combined with vitreous aspiration on visual acuity recovery and quality of life in acute angle closure glaucoma with persistent high intraocular pressure patients.Methods Eighty-two patients with acute angle closure glaucoma were divided into two groups according to the different surgical procedures, with 41 cases （41 eyes） in each group. The control group was treated by anterior chamber puncture and trabeculectomy. The treatment group was treated by trabeculectomy and vitreous aspiration.The surgical effects, functional bleb formation and complications were analyzed. The intraocular pressure, visual acuity and quality of life scores were compared between the two groups before and after operation.Results Compared with the control group, the total effective rate of treatment group was 97.56% （40/41）, which was higher than that of the control group （78.05%, 32/41）, the difference was significant （P〈0.05）. There was no significant difference in the intraocular pressure, visual acuity or quality of life score between the two groups （P〉0.05）. The level of visual acuity, physical function, substance function, social function and psychological function score of the treatment group were lower than those of the control group, the differences were significant （P〈0.05）; compared with the control group, the functional filtering bleb formation rate in the treatment group was significantly higher （92.68% vs. 38.61%）, the difference was significant （P〈0.05）. The incidence of complications in the treatment group [9.76% （4/41）] was lower than that in the control group [56.84% （11/41）], the difference was significant （P〈0.05）.Conclusions Trabeculectomy combined with vitrectomy in the treatment of acute angle-closure glaucoma sustained high intraocular pressure state, the effect is significant, and can reduce the patients’ IOP, promote vision recovery and functional filtration bleb formation, and it has high safety, can effectively improve the life quality of patients.