透明晶状体超声乳化术治疗早期闭角型青光眼的效果观察

Observation on the efficacy of phacoemulsification of transparent lens for the treatment of early stage of primary angle-closure glaucoma

目的观察透明晶状体超声乳化术治疗早期原发性闭角型青光眼的临床效果。方法对郑州大学第一附属医院眼科2018年10月至2020年1月不伴有白内障的早期原发性闭角型青光眼29例(31只眼)的临床资料进行回顾性分析。患者均接受超声乳化人工晶状体植入术。术后随访6个月,观察眼压、视力、前房深度、小梁虹膜夹角及术后并发症等。结果术后各个时间点眼压均较术前下降(均P<0.05)。随访期末:28只眼(90.32%)眼压≤21 mmHg(1 mmHg=0.133 kPa);最佳矫正视力(logMAR)为0.10±0.06较术前0.12±0.07提高(t=2.115,P=0.043);中央前房深度(3.01±0.16)mm深于术前的(1.94±0.14)mm(t=-28.643,P<0.001);小梁虹膜夹角(31.58°±3.98°)大于术前的(16.11°±3.05°)(t=-28.300,P<0.001);周边前房深度深于术前(P<0.001)。术后除5只眼(16.13%)轻度角膜水肿外,未见其他并发症。结论透明晶状体超声乳化人工晶状体植入术治疗早期原发性闭角型青光眼是有效的。

Objective To observe the clinical efficacy of phacoemulsification of clear lens for the treatment of early stage of primary angle-closure glaucoma(PACG).Methods This was a retrospective analysis.The clinical data of 31 eyes of 29 patients with early stage of primary angle-closure glaucoma without cataract in the First Affiliated Hospital of Zhengzhou University from Oct.2018 to Jan.2020 were collected.All patients received phacoemulsification with IOL implantation.The follow-up time was 6 months.The intraocular pressure,visual acuity,anterior chamber depth,trabeculum-iris angle and postoperative complications were observed.Results The intraocular pressure at all time points after operation was lower than that before operation(P<0.05).At the end of follow-up:The intraocular pressure was≤21 mmHg(1 mmHg=0.133 kPa)in 28 eyes(90.32%).The best corrected visual acuity at 6 months after surgery was improved(t=2.115,P=0.043).The postoperative central anterior chamber depth was(3.01±0.16)mm,which was deeper than the(1.94±0.14)mm preoperatively(t=-28.643,P<0.001).The trabecular iris included angle was(31.58°±3.98°),which was greater than the(16.11°±3.05°)preoperatively(t=-28.300,P<0.001).The depth of the peripheral anterior chamber after operation was deeper than that before operation(P<0.001).Five eyes(16.13%)developed mild corneal edema after operation.There was no other complication during the follow-up period.Conclusion The efficacy of phacoemulsification of transparent lens with IOL implantation for the treatment of early stage primary angle-closure glaucoma is effective.