两种不同手术方式治疗原发性闭角型青光眼合并白内障的临床效果、并发症探讨

Clinical Effect and Complication of Two Different Surgical Approaches in Treating Primary Angle-closure Glaucoma Combined with Cataract

目的探讨两种不同手术治疗方法在原发性闭角型青光眼合并白内障的临床效果、并发症情况。方法方便选取2013年7月—2017年7月科室收治的原发性闭角型青光眼合并白内障患者60例,根据手术方法不同分为对照组30例(单眼)与观察组30例(单眼)。对照组给予白内障超声乳化人工晶体植入手术进行治疗,观察组术在对照组基础上联合小梁切除术治疗,观察两组术后并发症发生率,比较两组临床疗效及对并发症的影响。结果观察组手术后眼压水平为(12.90±2.45)mm Hg,低于对照组(21.84±3.09)mm Hg(t=12.417 2,P<0.05);观察组手术后视力水平为(0.67±0.13),高于对照组(0.61±0.12)(t=1.857 5,P<0.05);两组手术后并发症发生率差异无统计学意义(χ~2=0.481,P>0.05)。结论将白内障超声乳化人工晶体植入联合小梁切除术用于原发性闭角型青光眼合并白内障患者中效果理想,但对于房角粘连已久的病例,行白内障超声乳化人工晶体植入术后往往需要加用局部降眼压药,联合小梁切除术才能较好的控制眼压,宜根据每例患者病情选择相应的手术方案。

Objective This paper tries to investigate the clinical effects and complications of two different surgical methods in primary angle-closure glaucoma combined with cataract. Methods A total of 60 patients with primary angle-closure glaucoma combined with cataract were convenient enrolled from July 2013 to July 2017. According to different surgical methods, they were divided into control group（30 cases）, monocular and observation group（30 cases）. The control group was treated with cataract phacoemulsification and intraocular lens implantation. The observation group was treated with trabeculectomy on the basis of the control group. The incidence of postoperative complications was observed in the two groups.The clinical efficacy and complications of the two groups were compared. Results In the observation group, the postoperative intraocular pressure（12.90±2.45） mm Hg was lower than that of the control group（21.84±3.09） mm Hg（t=12.417 2, P〈0.05）; the postoperative visual acuity of the observation group（0.67±0.13） was higher than that of the control group of（0.61±0.12）（t=1.857 5, P〈0.05）; the incidence of postoperative complications was not statistically significant（χ2=0.481, P〉0.05）.Conclusion The cataract phacoemulsification combined with trabeculectomy is ideal for primary angle-closure glaucoma combined with cataract, but phacoemulsification intraocular lens implantation has been used in patients with long-term angle of adhesion. It is often necessary to add local intraocular pressure-lowering drugs, and combined trabeculectomy can better control intraocular pressure. It is advisable to select the appropriate surgical plan according to the condition of each patient.