白内障合并急性闭角型青光眼视力恢复及眼压变化手术方案研究

Surgical Protocol for Visual Recovery and Intraocular Pressure Change in Cataract Complicated with Acute Angle Closure Glaucoma

目的:探讨青光眼滤过术与人工晶状体植入术联合白内障小切口囊外摘除术在老年白内障合并急性闭角型青光眼患者中的应用效果。方法:选取笔者所在医院2017年5月-2019年4月收治的老年白内障合并急性闭角型青光眼患者88例,依照手术方案不同分为研究组(n=44)、常规组(n=44)。常规组采用人工晶状体植入术联合白内障小切口囊外摘除术,研究组采用青光眼滤过术与人工晶状体植入术联合白内障小切口囊外摘除术。比较两组手术前后眼压、前房深度、视力水平及治疗过程中并发症发生率。结果:术后7 d研究组眼压低于常规组,前房深度高于常规组(P<0.05);术后1、3、6个月研究组视力水平均高于常规组(P<0.05);研究组并发症发生率(6.82%)与常规组(11.36%)比较,差异无统计学意义(P>0.05)。结论:青光眼滤过术与人工晶状体植入术联合白内障小切口囊外摘除术治疗老年白内障合并急性闭角型青光眼患者,可降低患者眼压,提高术后前房深度及视力水平,且安全性高。

Objective:To investigate the effect of glaucoma filtration and intraocular lens implantation combined with small incision extracapsular extraction in elderly patients with acute angle-closure glaucoma.Method:A total of 88 senile cataract complicated with acute angle-closure glaucoma in our hospital were selected and divided into the study group(n=44)and the conventional group(n=44)according to different surgical procedures.In the conventional group,intraocular lens implantation combined with small incision extracapsular cataract extraction was performed,while in the study group,glaucoma filtration and intraocular lens implantation combined with small incision extracapsular cataract extraction was performed.The intraocular pressure,anterior chamber depth and visual acuity before and after surgery and complication rate during treatment of the two groups were compared level.Result:The intraocular pressure in the study group was lower than that of the conventional group,and the anterior chamber depth was higher than that in the conventional group at 7 days after surgery,the differences were statistically significant(P<0.05).The visual acuity levels in the study group were higher than those in the conventional group at 1,3 and 6 months after surgery,the differences were statistically significant(P<0.05).The complication rate during treatment in the study group was 6.82%,compared with 11.36%in the conventional group,there was no statistically significant difference(P>0.05).Conclusion:Glaucoma filtration and intraocular lens implantation combined with small incision extracapsular extraction for elderly patients with acute angle-closure glaucoma can reduce intraocular pressure,improve anterior chamber depth and visual acuity,and is safe.