青白联合术对PACG合并白内障患者视力及SIt、BUT的影响

Effect of Combined Innocence Surgery on Visual Acuity SIt and BUT in Patients with PACG and Cataract

目的探究青白联合术对原发性闭角型青光眼(PACG)合并白内障患者视力及泪液分泌试验(SIt)、泪膜破裂时间(BUT)的影响。方法回顾性分析2014年3月至2018年9月徐州市铜山区人民医院60例PACG合并白内障患者为试验对象,按手术方法分为观察组和对照组,各30例。对照组采用白内障联合房角分离术治疗,观察组采用青白联合术治疗。2组术后均持续观察3个月。观察2组术前及术后20 d眼压、视力、前房深度、泪膜状态,以及手术成功率和术后并发症。结果与术前比,术后20 d 2组眼压明显降低,且观察组低于对照组(P<0.05);2组视力、前房深度均升高,且观察组高于对照组(P<0.05)。与术前比,术后20 d 2组FL评分均升高,且观察组高于对照组(P<0.05);2组SIt、BUT及泪膜正常干涩图像率均下降或缩短,且观察组低于或短于对照组(P<0.05)。手术治疗后,观察组与对照组手术成功率分别为96.66%、93.33%,差异无统计学意义(P>0.05);观察组并发症发生率明显低于对照组(P<0.05)。结论对PACG合并白内障患者实施青白联合术治疗更能恢复患者视力,控制眼压,提高眼膜恢复,降低并发症的发生,值得临床推广应用。

Objective To explore the effect of combined innocence and whiteness on vision,SIt,and BUT in patients with PACG and cataract.Methods A retrospective analysis was performed on 60 patients with PACG and cataract in our hospital from March 2014 to September 2018.The patients were divided into observation group and control group according to the surgical method,30 cases each.The control group was treated with cataract and atrial angle separation,and the observation group was treated with green and white.Postoperative observation was continued for 3 months in both groups.Intraocular pressure,visual acuity,anterior chamber depth,tear film status,success rate and postoperative complications were observed before and 20 days after operation.Results Compared with the preoperative,the IOP of the two groups decreased significantly 20 days after operation,and the IOP of the observation group was lower than that of the control group(P<0.05);the visual acuity and the depth of anterior chamber of the two groups increased,and the IOP of the observation group was higher than that of the control group(P<0.05).Compared with that before operation,FL score of the two groups increased 20 days after operation,and the observation group was higher than that of the control group(P<0.05);the sit,but and tear film normal dry image rate of the two groups were decreased or shortened,and the observation group was lower or shorter than that of the control group(P<0.05).After operation,the success rate of operation in the observation group and the control group was 96.66%and 93.33%,respectively,with no significant difference(P>0.05);The incidence of complications in the observation group was significantly lower than that in the control group(P<0.05).Conclusion The combination of green and white surgery for patients with PACG combined with cataract can restore the patient's vision and control intraocular pressure,but at the same time increase the incidence of dry eye,and take corresponding measures during surgery.