EX-PRESS植入联合超乳治疗合并白内障的急性闭角型青光眼持续高眼压

EX-PRESS glaucoma drainage device combined with phacoemulsification for cataract patients with acute angle-closure glaucoma and ocular hypertension

目的:探讨EX-PRESS青光眼引流器植入联合超声乳化吸出术治疗合并白内障的急性闭角型青光眼持续高眼压患者的临床效果和安全性。方法:选择2016-01/2017-01在我院就诊的急性闭角型青光眼合并白内障持续高眼压患者作为研究对象,患者均给予EX-PRESS青光眼引流器植入联合超声乳化吸出术治疗。观察手术前后中央前房深度、术后1、4、8、12、24、48wk的眼压、矫正视力,记录手术的治疗成功率和术中、术后并发症发生情况。结果:术前患者前房深度为1. 974±0. 182mm,术后患者前房深度为2. 961±0. 175mm,差异有统计学意义(P<0. 01)。术后1、4、8、12、24、48wk时患者眼压与术前相比较均显著降低,差异有统计学意义(P<0. 05)。术后12、24、48wk成功患者所占比例逐渐降低,但总成功率均为100%。术后48wk患者矫正视力显著较术前改善,差异有统计学意义(P<0. 05)。本组患者均未出现严重术中和术后并发症。结论:EX-PRESS青光眼引流器植入联合超声乳化吸出术治疗合并白内障的急性闭角型青光眼持续高眼压患者安全有效。

AIM： To investigate the clinical efficacy and safety of EX-PRESS glaucoma drainage combined with phacoemulsification in the treatment of patients with acute angle-closure glaucoma and ocular hypertension with cataract. METHODS： Patients with acute angle-closure glaucoma and cataract sustained high intraocular pressure who were admitted to our hospital from January 2016 to January 2017 were enrolled in this study. All patients were treated with EX-PRESS glaucoma drainage device combined with phacoemulsification. The anterior chamber depth before and after operation, intraocular pressure, corrected visual acuity at 1, 4, 8, 12, 24, and 48wk after surgery were performed. The success rate of surgery and intraoperative and postoperative complications were recorded. RESULTS： The anterior chamber depth of the preoperative patients was 1.974±0.182mm, and that after operation was 2.961±0.175mm. The difference was statistically significant（P〈0.01）. At 1, 4, 8, 12, 24, and 48wk, the intraocular pressure was significantly lower than that before surgery（P〈0.05）. The proportion of successful patients at 12, 24, and 48wk after surgery gradually decreased, but the total success rate was 100%. The corrected visual acuity of the patients was significantly improved compared with the preoperative 48wk after operation, and the difference was statistically significant（P〈0.05）. There were no serious intraoperative and postoperative complications in this group of patients. CONCLUSION： EX-PRESS glaucoma drainage combined with phacoemulsification is safe and effective in cataract patients with acute angle-closure glaucoma with high intraocular pressure.