超声乳化白内障吸除联合人工晶状体植入、房角分离术治疗闭角型青光眼合并白内障患者的疗效分析

Analysis of curative effect by phacoemulsification combined with intraocular lens implantation and goniosynechialysis in the treatment of angle-closure glaucoma complicated with cataract

目的评价超声乳化白内障吸除联合人工晶状体植入、房角分离术治疗闭角型青光眼合并白内障患者的疗效。方法 34例(39眼)闭角型青光眼合并白内障患者,随机分为1组11例(13眼)与2组23例(26眼)。1组完成超声乳化白内障吸除联合人工晶状体植入、房角分离术治疗,2组给予超声乳化白内障吸除联合人工晶状体植入治疗。观察两组患者视力、眼压、房角度数等情况,并进行比较。结果 1组患者均完成白内障超声乳化联合人工晶体植入、房角分离术,无后囊膜破裂等并发症。2组患者亦完成白内障超声乳化联合人工晶体植入,术无后囊膜破裂等并发症。两组手术前后组内视力、眼压、房角度数比较,差异具有统计学意义(P<0.05);两组术前眼压、视力比较,差异无统计学意义(P>0.05);两组术后眼压比较差异无统计学意义(P>0.05),1组术后视力为(0.55310±0.25513),明显优于2组的(0.33740±0.24884),两组比较,差异具有统计学意义(P<0.05)。两组术前房角比较,差异无统计学意义(P>0.05),两组术后房角除9点方向外比较,差异具有统计学意义(P<0.05)。患者术后浅前房得到改善,房角增宽、高眼压及前房炎症反应等得到控制。结论超声乳化白内障吸除联合人工晶状体植入术、房角分离术是治疗闭角型青光眼合并白内障患者的有效治疗途径,对房角的改善更为有利,值得推广。

Objective To evaluate curative effect by phacoemulsification combined with intraocular lens implantation and goniosynechialysis in the treatment of angle-closure glaucoma complicated with cataract. Methods A total of 34 patients (39 eyes) of angle-closure glaucoma complicated with cataract were randomly divided into group 1 with 11 cases (13 eyes) and group 2 with 23 cases (26 eyes). Group 1 received phacoemulsification combined with intraocular lens implantation and goniosynechialysis for treatment, and group 2 received phacoemulsification combined with intraocular lens implantation for treatment. Observation wasmade on vision, intraocular pressure and chamber angle degree in both groups for comparison. Results Group1 received successful phacoemulsification combined with intraocular lens implantation and goniosynechialysis,without complications of posterior capsular rupture. Group 2 received successful phacoemulsification combinedwith intraocular lens implantation, without complications of posterior capsular rupture. The difference of vision,intraocular pressure and chamber angle degree before and after operation had statistical significance in both groups(P<0.05). There was no statistically significant difference of preoperative intraocular pressure and vision betweenthe two groups (P>0.05). The difference of postoperative intraocular pressure also had no statistical significancebetween the two groups (P>0.05). Group 1 had obviously better postoperative vision as (0.55310±0.25513) than(0.33740±0.24884) in group 2, and their difference had statistical significance (P<0.05). There was no statisticallysignificant difference of preoperative chamber angle degree between the two groups (P>0.05). The differences ofpostoperative chamber angle degree between the two groups had statistical significance, with exception of 9 clock direction (P<0.05). Both groups had improved postoperative shallow anterior chamber and controlled widened chamber, intraocular hypertension and inflammatory reaction in anterior chamber. Conclusion Combination of phacoemulsification, intraocular lens implantation and goniosynechialysis is an effective treatment measure for angle-closure glaucoma complicated with cataract patients. This method is beneficial for improving chamber angle, and it is worth promoting.