超声乳化联合前房角分离术治疗合并老年性白内障闭角型青光眼的疗效观察

Clinical Observation of Phacoemulsification combined with Anterior Chamber Angle Separation for Angle-closure Glaucoma with Senile Cataract

目的探讨超声乳化联合前房角分离术治疗合并老年性白内障的闭角型青光眼疗效观察.方法选取我院(2016年1月至2018年1月)收治的闭角型青光眼合并白内障患者116例,根据不同治疗方法分为两组,对照组(n=58)给予超声乳化联合小梁切除术治疗,观察组(n=58)给予超声乳化联合前房角分离术治疗,对比两组患者治疗前后中央前房深度、眼压、视力散光度数、裸眼视力、临床疗效、再粘连率和并发症发生率.结果两组患者治疗前后中央前房深度、眼压、视力散光度数、裸眼视力对比差异不明显(P>0.05);治疗后观察组中央前房深度、裸眼视力明显高于对照组,眼压、视力散光度明显低于对照组,差异具有统计学意义(P<0.05).两组患者临床疗效对比93.10%vs75.86%差异明显,具有统计学意义(P<0.05).两组患者再粘连率和并发症发生率1.72%、12.07%vs8.62%、24.14%差异不明显,具有统计学意义(P<0.05).结论超声乳化联合前房角分离术可有效加大中央前房深度,降低眼压和视力散光度数,提高视力,且安全可靠,分析是该方法可有效摘除病变晶状体,并通过置入人工晶状体,避免瞳孔阻滞,达到治疗效果.而小梁切除术虽然有效,但其有眼压水平限制,且操作复杂,因此容易出现创伤,因此不仅效果较差吗,还容易引发并发症.

Objective To investigate the efficacy of phacoemulsification combined with anterior chamber angle separation in the treatment of angle-closure glaucoma with senile cataract. Methods 116 patients with angle-closure glaucoma complicated with cataract were selected and divided into two groups according to different treatment methods. The control group (n=58) was treated with phacoemulsification combined with trabeculectomy. The observation group (n=58) was treated with phacoemulsification combined with anterior chamber angle separation. The central anterior chamber depth, intraocular pressure and visual acuity were compared between the two groups before and after treatment. Astigmatism, naked eye vision, clinical efficacy, re-adhesion rate and complication rate. Results There was no significant difference in central anterior chamber depth, intraocular pressure, visual astigmatism and naked eye vision between the two groups before and after treatment (P >0.05);after treatment, the central anterior chamber depth and naked eye vision of the observation group were significantly higher than those of the control group, and the intraocular pressure and visual astigmatism were significantly lower than those of the control group, with statistical significance (P< 0.05). The clinical efficacy of the two groups was 93.10% vs 75.86%, with significant difference (P< 0.05). There was no significant difference in the rates of re-adhesion and complications between the two groups (1.72%, 12.07% vs 8.62%, 24.14%, P< 0.05). Conclusion Phacoemulsification combined with anterior chamber angle separation can effectively increase the central anterior chamber depth, reduce intraocular pressure and visual astigmatism, improve visual acuity, and is safe and reliable. The analysis shows that this method can effectively remove the diseased lens and avoid pupil block by implanting intraocular lenses. Although trabeculectomy is effective, it has the limitation of intraocular pressure level and complicated operation, so it is prone to trauma, so it is not only ineffective, but also easy to cause complications.