白内障超声乳化结合人工晶状体植入术对闭角型青光眼合并白内障患者眼压及视力的影响

Impacts of cataract phacoemulsification combined with intraocular lens implantation on intraocular pressure and vision in patients with angle-closure glaucoma complicated with cataract

目的对闭角型青光眼合并白内障患者实施白内障超声乳化+人工晶状体植入术,分析其对患者眼压及视力的影响。方法选取泉州市第一医院眼科2017年9月~2018年9月收治的90例(90眼)闭角型青光眼合并白内障患者分组研究,以数字随机表法分为观察组(n=45)与对照组(n=45),对照组患者行小梁切除术,观察组行白内障超声乳化+人工晶状体植入术+房角分离术,对两组手术结果进行比较。结果术前两组视力、眼压差异均无统计学意义(t=0.949、0.192,P>0.05);术后6个月,观察组上述指标与对照组相比,差异有统计学意义(t=2.949、8.636,P<0.05)。两组术前前房深度差异无统计学意义(t=0.387,P>0.05);两组术后前房深度与术前比较,差异均有统计学意义;观察组术后6个月前房深度与对照组相比,差异有统计学意义(t=8.497,P<0.05)。术后观察组并发症发生率为8.88%,低于对照组的24.44%(χ2=3.920,P<0.05)。结论对闭角型青光眼合并白内障患者而言,实施白内障超声乳化的同时植入人工晶状体安全有效,联合房角分离术可恢复房角功能,降低患者眼压,还可提高视力,且并发症较少,值得应用。

Objective To perform cataract phacoemulsification combined with intraocular lens implantation in patients with angle-closure glaucoma complicated with cataract,and to analyze their impacts on intraocular pressure and vision.Methods 90 cases(90 eyes)of angle-closure glaucoma complicated with cataract admitted to the ophthalmology department of Quanzhou First Hospital from September 2017 to September 2018 were selected and divided into the observation group(n=45)and the control group(n=45)by number random table method.The patients in the control group were given trabeculectomy,while the patients in the observation group were given cataract phacoemulsification combined with intraocular lens implantation and goniosynechialysis,and the operation results of the two groups were compared.Results At baseline,there was no significant difference in vision and intraocular pressure between the two groups(t=0.949,0.192,P>0.05).6 months after operation,the above indexes in the observation group were significantly different from those in the control group(t=2.949,8.636,P<0.05).There was no significant difference in anterior chamber depth between the two groups at baseline(t=0.387,P>0.05).Compared with that before the operation,there was significant difference in anterior chamber depth in both of the two groups.There was significant difference in anterior chamber depth between the observation group and the control group 6 months after operation(t=8.497,P<0.05).After operation,the complication rate in the observation group was 8.88%,lower than 24.44%in the control group(χ2=3.920,P<0.05).Conclusion For patients with angle-closure glaucoma complicated with cataract,cataract phacoemulsification and intraocular lens implantation are safe and efficacious.Combined with goniosynechialysis,they are beneficial to restore gonial function,reduce intraocular pressure of patients,and improve vision with a lower complication rate,which is worthy of application.