超声乳化白内障吸除联合人工晶体植入及房角分离术对急性闭角型青光眼的疗效及安全性分析

The curative effect and safety of phacoemulsification combined with intraocular lens implantation and goniosynechialysis in the treatment of acute primary angle-closure glaucoma

目的观察超声乳化白内障吸除联合人工晶体植入及房角分离术对急性闭角型青光眼(acute primary angle-closure glaucoma,APACG)的临床疗效及其安全性。方法原发性APACG患者92例,根据非随机临床同期对照研究及患者自愿原则分为观察组(n=45例)和对照组(n=47例),观察组行超声乳化白内障吸除联合人工晶体植入及房角分离术治疗,对照组行超声乳化联合人工晶状体植入及小梁切除术治疗,比较两组临床疗效、术后并发症及房角开合情况,记录术前、术后1周、术后3月眼压、最佳矫正视力变化。结果两组临床疗效、并发症发生情况比较,差异均无统计学意义(P>0.05)。术后1周观察组眼压低于对照组,最佳矫正视力高于对照组(P<0.05);术后3月两组眼压、最佳矫正视力、前房深度、房角开合情况均改善,但组间比较差异无统计学意义(P>0.05)。结论超声乳化白内障吸除联合人工晶体植入及房角分离术治疗APACG临床疗效显著,术后眼压控制、视力恢复效果好,前房深度增加,并发症少,安全性高,具有临床应用价值。

Objective To observe the clinical curative effect and safety of phacoemulsification combined with intraocular lens implantation(IOL)and goniosynechialysis in the treatment of acute primary angle-closure glaucoma(APACG).Methods A total of 92 APACG patients who were admitted to ophthalmology department of our hospitals were enrolled.According to the non-randomized clinical concurrent control study and voluntary principle of patients,they were divided into observation group(n=45)and control group(n=47).The observation group was treated with phacoemulsification combined with IOL and goniosynechialysis while the control group was treated with phacoemulsification combined with IOL and trabeculectomy.The clinical curative effect,postoperative complications and opening and closing of chamber angle were compared between the two groups.The changes in intraocular pressure and best corrected visual acuity(BCVA)before and after 1 week and 3 months of surgery were recorded.Results There were no significant differences in clinical curative effect and occurrence of complications between the two groups(P>0.05).After 1 week of surgery,intraocular pressure in the observation group was lower than that in the control group while BCVA was higher than that in the control group(P<0.05).After 3 months of surgery,intraocular pressure,BCVA,anterior chamber depth and opening and closing of chamber angle in both groups were significantly improved,but the differences between the two groups were not statistically significant(P>0.05).Conclusion The clinical curative effect of phacoemulsification combined with IOL and goniosynechialysis is significant in the treatment of APACG.The postoperative intraocular pressure control and visual recovery effect are good,and anterior chamber depth is increased with fewer complications and higher safety.