联合手术治疗残余性青光眼的疗效分析

An Efficacy Analysis of Residual Glaucoma Treated by Combined Operation

为了寻找治疗残余性青光眼选择最佳的手术方式,达到较好的治疗效果.随机从云南省第一人民医院2014年10月至2017年4月收治的残余性青光眼患者中抽取68例68眼,分为对照组和研究组,每组34例.对照组采用常规复合式小梁切除术治疗,研究组采用白内障超声乳化联合复合式小梁切除及房角分离术治疗.随访90天,分析两种不同手术方式治疗残余性青光眼的疗效及特点.结果表明:研究组残余性青光眼患者通过治疗后1 d、7 d、30 d和90 d的眼压分别有一定的降低,眼压控制明显优于对照组(P<0.05);研究组术后1 d、7 d、30 d和90 d,眼压有效控制的人数明显更多(P<0.05).对残余性青光眼应用联合白内障超声乳化+房角分离+复合小梁切除术治疗,可以起到较好的治疗效果,能够在短时间内控制患者的眼压,并有较好的远期疗效,能有效保护视神经及视野,在临床青光眼的治疗中可以推荐和应用.

This paper aims to find a comparatively effective surgical method in treating residual glaucoma so as to achieve better effects. Sixty-eight eyes of 68 cases diagnosed with residual glaucoma in the First People＇s Hospital of Yunnan Province from October 2014 to April 2017 were enrolled to this study and divided into a study group and a control group randomly. Each group included 34 cases. The control group received the treatment of compound trabeculectomy,while the study group received compound trabeculectomy combined with phacoemulsification and goniosychialysis. The therapeutic effects and characteristics of the two methods in treating residual glaucoma were analyzed and observed in a 90-day follow-up. The results revealed that the mean intraocular pressure in the study group at 1 d,7 d,30 d and 90 d after surgery declined,which were controlled better than those in the control group（ P 0. 05）. The cases with effective control in intraocular pressure at 1 d,7 d,30 d and 90 d after surgery in the study group were more than those in the control group（ P 0. 05）. Compound trabeculectomy combined with phacoemulsification and goniosychialysishad was effective in treating residual glaucoma,which can well control the intraocular pressure within short time. For the long term,it can protect nerve fiber and visual field effectively. Therefore,this method is worthy of recommendation and application in clinical treatment.