白内障超声乳化联合人工晶状体植入术治疗原发性闭角型青光眼伴白内障的疗效

The effect of cataract phacoemulsification combined with intraocular lens implantation for primary angle closure glaucoma with cataract

目的探讨白内障超声乳化联合人工晶状体植入术治疗原发性闭角型青光眼伴白内障的疗效。方法选取2015年2月至2016年10月在我院治疗的原发性闭角型青光眼伴白内障患者82例103眼,均给予白内障超声乳化联合人工晶状体植入术治疗,观察治疗前后视力、眼压、中央前房深度(ACD)、房角开放距离500(AOD500)、房角开放情况以及并发症。结果术后3个月、6个月、12个月最佳矫正视力明显较术前改善(P<0.05);患者术后3个月、6个月和12个月眼压明显较术前降低(P<0.05);术后6个月和12个月眼压分别为(15.43±1.55)mm Hg和(15.50±1.60)mm Hg,高于术后3个月眼压(P<0.05),但明显低于术前(P<0.05);患者术后3个月、6个月和12个月ACD和AOD500明显较术前改善(P<0.05);术后3个月、6个月和12个月房角关闭情况明显较术前改善(P<0.05),其中术后12个月房角开放眼数达28眼,占27.18%;术后未出现人工晶体夹持、黄斑囊样水肿、角膜失代偿等并发症。结论白内障超声乳化联合人工晶状体植入术治疗原发性闭角型青光眼伴白内障有较好的效果,能改善患者视力、降低眼压、开放房角。

Objetive To investigate the effect of phacoemulsification combined with intraocular lens implantation in primary angle closure glaucoma with cataract. Methods 82 cases （103 eyes） of primary angle closure glaucoma with cataract were treated in our hospital from February 2015 to October 2016 with phacoemulsification and intraocular lens implantation. The visual acuity, intraocular pressure, central anterior chamber depth （ACD）, open angle of atrial angle 500 （AODs0o）, atrial angle opening and complications before and after treatment were observed. Results The best corrected visual acuity at 3months, 6months, 12months after operation were significantly improved than that before operation （P〈 0.05）; The intraocular pressure of the patients at 3 months, 6 months and 12 months after surgery were significantly lower than that before operation （P〈 0.05）; The intraocular pressure at 6 and 12months after operation were （15.43 ±1.55） mmHg and （15.50 ±1.60） mmHg, which was higher than that at postoperative 3 months （P〈 0.05）, but significantly lower than that before operation （P〈 0.05）;at 1, 6 months and 12 months after operation, ACD and AOD500 were significantly improved than those before operation（P〈 0.05）; At 3, 6, 12 months after operation, the angle closure were significantly better than that before operation （P〈 0.05）, in which the number of eyes of anterior angle opening at 12 months after operation was 28 eyes, accounting for 27.18%; No complications such as intraocular lens clamping, cystoid macular edema and corneal decompensation occurred. Conclusion Phacoemulsification combined with intraocular lens implantation is effective in the treatment of primary angle closure glaucoma with cataract, which can improve the vision, reduce intraocular pressure and open anterior angle.