超声乳化联合小梁切除术在闭角型青光眼合并白内障治疗中的应用价值

Application Value of Phacoemulsification Combined with Trabeculectomy in the Treatment of Angle-closure Glaucoma and Cataract

目的探讨超声乳化联合小梁切除术对闭角型青光眼合并白内障的治疗效果及安全性。方法方便选取该院2015年8月—2017年1月收治的86例(86眼)闭角型青光眼合并白内障患者,以随机数字表法分为对照组与观察组各43例(43眼),对照组与观察组分别行白内障超声乳化吸出+人工晶体植入术与白内障超声乳化吸出+人工晶状体植入联合小梁切除术,对两组患者手术效果进行观察。结果术前,两组患者眼压、视力、散光度差异无统计学意义(P>0.05),观察组术后眼压、视力、散光度分别为(13.01±2.45)mm Hg、(0.79±0.13)、(0.72±0.24)D,明显优于对照组(16.24±2.63)mm Hg、(0.64±0.15)、(0.81±0.12)D,差异有统计学意义(t=5.893、4.955、4.199,P<0.05);观察组与对照组术后并发症发生率分别为4.65%、9.30%,差异无统计学意义(χ2=0.716,P>0.05)。结论超声乳化联合小梁切除术有助于闭角型青光眼合并白内障患者提高视力,控制眼压,值得临床推广。

Objective To study the effect and safety of phacoemulsification combined with trabeculectomy in the treatment of angle-closure glaucoma and cataract. Methods 86 cases（86 eyes） of patients with angle-closure glaucoma and cataract admitted and treated in our hospital from August 2015 to January 2017 were convenient selected and randomly divided into two groups with 43 cases in each（43 eyes）, and the control group were treated with phacoemulsification and intraocular lens implantation, while the observation group were treated with trabeculectomy on the basis of the control group, and the operation effect was compared between the two groups. Results The differences in the eye pressure, vision and astigmatism between the two groups before surgery（P〉0.05）, and the eye pressure, vision and astigmatism in the observation group after surgery were respectively（13.01±2.45）mm Hg,（0.79±0.13）,（0.72±0.24）D, which were obviously better than those in the control group,（16.24 ±2.63）mm Hg,（0.64 ±0.15）,（0.81 ±0.12）D, and the differences were statistically significant（t =5.893,4.955,4.199,P〈0.05）, and the incidence rate of postoperative complications in the observation group and in the control group was respectively 4.65%,9.30%,（χ^2=0.716,P〉0.05）. Conclusion The phacoemulsification combined with trabeculectomy contributes to improving the visions and controlling the eye pressures of patients with angle-closure glaucoma and cataract, and it is worth clinical promotion.