超声乳化吸除联合人工晶体植入及小梁切除术治疗老年白内障并急性闭角型青光眼的效果

Effect of phacoemulsification of cataract,intraocular lens implantation combined with glaucoma trabeculectomy in the treatment of senile cataract with acute angle-closure glaucoma

目的:探讨白内障超声乳化吸除术(PHACO)、人工晶体植入术(LFCM)及青光眼小梁切除术(TM)三种手术联合治疗老年白内障并急性闭角型青光眼的临床效果。方法:抽取2015年1月至2019年12月晋中市第二人民医院收治的老年白内障并急性闭角型青光眼患者89例,依据随机数表将其分为两组。参照组45例给予PHACO联合LFCM治疗,研究组44例在参照组基础上联合TM治疗,比较两组治疗效果、相关指标及术后并发症情况。结果:研究组临床治疗总有效率(97.78%,43/44)高于参照组(82.22%,37/45),差异有统计学意义(χ2=4.302,P<0.05)。治疗后,两组视力、前房深度、视觉相关生活质量评分高于治疗前(P<0.05),眼压低于治疗前(P<0.05),且研究组对应值更高或更低(t=8.146、1.988、4.760、5.461,均P<0.05)。研究组术后并发症发生率(2.27%,1/44)低于参照组(17.78%,8/45),差异有统计学意义(χ2=4.301,P<0.05)。结论:三种手术联合治疗老年白内障并急性闭角型青光眼效果良好,能够有效改善患者视功能,加宽前房深度,且安全性较好。

Objective To analyze the clinical effect of phacoemulsification of cataract,intraocular lens implantation combined with glaucoma trabeculectomy on senile cataract with acute angle-closure glaucoma.Methods A total of 89 elderly cataract patients with acute angle-closure glaucoma admitted to Jinzhong Second People’s Hospital from January 2015 to December 2019 were selected,and they were divided into reference group and study group by random number table.Forty-five cases in the reference group were given cataract ultrasound emulsification aspiration combined with intraocular lens implantation,while 44 cases in the study group were treated with glaucoma trabeculectomy on the basis of the reference group.The treatment effects,related indicators and postoperative complications were compared between the two groups.Results The total effective rate of clinical treatment in the study group(97.78%,43/44)was higher than that in the reference group(82.22%,37/45),and the difference was statistically significant(χ2=4.302,P<0.05).After treatment,the visual acuity,anterior chamber depth,and scores of vision-related quality of life in the two groups were higher than those before treatment(P<0.05),and intraocular pressure was lower than that before treatment(P<0.05),and the corresponding values of the study group were higher or lower(t=8.146,1.988,4.760,5.461,all P<0.05).The incidence of postoperative complications in the study group(2.27%,1/44)was lower than that in the reference group(17.78%,8/45),and the difference was significant(χ2=4.301,P<0.05)Conclusions The combined treatment of three types of surgery for senile cataract and acute angle-closure glaucoma has good effect,and can effectively improve the visual function of patients,widen the depth of the anterior chamber,and has good safety.