超声乳化联合房角分离与联合小梁切除术治疗高龄急性闭角型青光眼合并白内障的疗效对比

Comparison of the efficacy of ultracoemulsification combined with angle separation andtrabeculectomy on advanced acute angle closure glaucoma combined with cataract

目的对比观察在超声乳化白内障吸除+人工晶体植入术的基础之上,联合房角分离术与小梁切除术治疗高龄急性闭角型青光眼合并白内障的临床疗效。方法选择80~92岁高龄青光眼合并白内障患者42例(42眼),所有患者均接受超声乳化白内障吸除+人工晶体植入术,按照接受不同青光眼手术方法分为两组,A组21例联合房角分离术,B组21例联合小梁切除术,观察两组患者术前、术后1个月患者的眼压、视力、前房深度、并发症等。结果治疗后A组的临床疗效优于B组(P<0.05)。两组患者术前的视力、眼压及前房深度比较,差异均无统计学意义(P>0.05),术后1个月两组视力、眼压及前房深度均显著改善(P<0.05),A组改善更明显(P<0.01)。术后1个月内,两组并发症发生率比较差异无统计学意义(P>0.05)。结论高龄青光眼合并白内障患者采用超声乳化白内障吸除人工晶体植入联合房角分离术治疗的临床疗效更好,可有效改善视力、眼压及前房深度且不会增加并发症,值得临床推广。

Objective To compare the clinical effects of angle separation and trabeculectomy in the treatment of elderly patients with acute angle closure glaucoma combined with cataract base on phacoemulsification cataract aspiration+intraocular lens implantation.Methods 42 cases(42 eyes)of 80-92-year-old glaucoma and cataract patients were selected.All patients received phacoemulsification cataract aspiration+intraocular lens implantation.And they were divided into two groups according to different glaucoma surgery methods.Group A(21 cases)were combined with angle separation,and group B(21 cases)were combined with trabeculectomy.Ang then,intraocular pressures,visual acuities,anterior chamber depths and complications of the two groups were observed before operation and 1 month after operation.Results After treatment,the clinical efficacy of the group A was better than that of the group B(P<0.05).There was no statistically significant difference in the visual acuities,intraocular pressures and anterior chamber depths of the two groups before operation(P>0.05),they significantly improved in the two groups one month after operation(P<0.05),and the improvement in the group A was more obvious(P<0.01).Within one month after surgery,there was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusion For elderly patients with glaucoma and cataracts,phacoemulsification cataract aspiration combined with angle separation has better clinical efficacy,which can effectively improve vision,intraocular pressure and anterior atrial depth without increasing complications,and thus is worthy of clinical promotion.