超声乳化联合小梁切除术对原发性闭角型青光眼合并白内障患者视力恢复的影响

The effects of ultrasonic emulsification combined with trabeculectomy on visual acuity recovery in patients with primary angle-closure glaucoma complicated by cataract

目的探讨超声乳化联合小梁切除术对原发性闭角型青光眼(primary angle closure glaucoma,PACG)合并白内障患者视力恢复的影响。方法选取2014年1月值2016年1月收治的PACG合并白内障患者108例130眼,随机数字表法将患者分为观察组与对照组,每组54例65眼。观察组采用行超声乳化、人工晶体植入联合小梁切除术,对照组采用小梁切除术联合丝裂霉素C(MMC)清润复合术。比较2组临床疗效、眼压、视力恢复等情况的差异。结果观察组手术成功率与视力恢复率均明显高于对照组,差异有统计学意义(P<0.05)。手术前,2组眼压、视力、平均光敏感度(mean sensitivity,MS)与平均缺损(mean defect,MD)值比较差异无统计学意义(P>0.05),手术后,全部患者眼压、MD值明显低于手术前,视力、MS值明显高于手术前,手术前后比较差异有统计学意义(P<0.05),其中观察组眼压、MD值明显低于对照组,视力、MS值明显高于对照组,2组比较差异有统计学意义(P<0.05)。结论超声乳化联合小梁切除术可通过降低PACG合并白内障患者眼压,纠正视野缺损程度,从而促进视力恢复,值得临床推广应用。

Objective To investigate the effects of ultrasonic emulsification combined with trabeculectomy on visual acuity recovery in patients with primary angle-closure glaucoma（ PACG） complicated by cataract. Methods A total of 130 eyes of 108 patients with PACG complicated by cataract who were admitted and treated in Ophthalmology Department of our hospital from January 2014 to January 2016 were enrolled in the study. The patients were divided into observation group（ 65 eyes of 54 cases） and control group（ 65 eyes of 54 cases） according to random number table. The patients in observation group were treated by ultrasonic emulsification,intraocular lens implantation combined with rabeculectomy,whereas those in control group were treated by trabeculectomy combined with mitomycin C（ MMC）. The clinical curative effects,intraocular pressure and visual acuity recovery were observed and compared between the two groups. Results The success rate and visual recovery rate in observation group were significantly higher than those in control group（ P 0. 05）. Before surgery,there were no significant differences in intraocular pressure,visual acuity,mean sensitivity（ MS） value and mean defect（ MD） value between the two groups（ P 0. 05）. Nevertheless,after surgery,intraocular pressure and MD value in all the patients were significantly lower than those before surgery,whereas visual acuity and MS value were significantly higher than those before surgeryund（ P 0. 05）. Moreover intraocular pressure and MD value in observation group were significantly lower than those in control group,while visual acuity and MS value were significantly higher than those in control group（ P 0. 05）.Conclusion Ultrasonic emulsification combined with trabeculectomy can promote the visual acuity recovery by reducing intraocular pressure and correcting visual field defect of patients with PACG complicated by cataract. Therefore,it is worthy of clinical popularization and application.