超声乳化合并小瞳下房角分离术治疗白内障合并闭角型青光眼患者的短期随访研究

Short-term follow-up study of phacoemulsification combined with small pupil inferior atrial angle separation for cataract with angle-closure glaucoma

目的分析超声乳化(PE)合并小瞳下房角分离术(GSL)治疗白内障合并闭角型青光眼(ACG)患者的效果。方法选取2018年11月至2020年8月该院收治的92例白内障合并ACG患者,依照随机数字表法分为两组,各46例。对照组接受PE合并小梁切除术(TE)治疗,观察组接受PE+GSL治疗,比较两组治疗效果。结果眼压:两组术后1 d、术后1个月、6个月眼压均较术前有所降低,而观察组术后1 d、1个月较对照组高(P<0.05),两组术后6个月比较,差异无统计学意义(P>0.05)。最佳矫正视力(BCVA):术后1 d、术后1个月、6个月,两组BCVA均较术前升高(P<0.05),而两组间比较,差异无统计学意义(P>0.05)。前房深度:术后3个月、6个月,两组前房深度均增加(P<0.05),而两组间比较,差异无统计学意义(P>0.05)。前房角度:术后3个月、6个月,两组前房角度均较术前增加,且观察组较对照组大(P<0.05)。并发症:观察组并发症发生率(13.04%)较对照组(36.96%)低(P<0.05)。结论PE+GSL治疗白内障合并ACG患者,能有效矫正其视力水平,改善前房深度、角度,且并发症少。

Objective To analyze the effect of phacoemulsification(PE)combined with small pupil inferior atrial angle separation(GSL)in the treatment of cataract with angle closure glaucoma(ACG).Methods A total of 92 patients with cataract complicated with ACG in the hospital(November 2018 to August 2020)were selected and divided into two groups according to random number table method,46 cases in each group.The control group was treated with PE combined with trabeculectomy(TE),and the observation group was treated with PE+GSL.The therapeutic effects of the two groups were compared.Results Compared with preoperation,intraocular pressure decreased at 1 d,1 month and 6 months after surgery,and the observation group was higher than the control group at 1 d and 1 month after surgery(P<0.05),and there was no significant difference between the two groups at 6 months after surgery(P>0.05).Best corrected visual acuity(BCVA):1 d after surgery,1 month after surgery,6 months after surgery,BCVA in both groups was higher than that before surgery(P<0.05),but there was no significant difference between the two groups(P>0.05).Anterior chamber depth:anterior chamber depth increased in both groups at 3 and 6 months after surgery(P<0.05),but there was no significant difference between the two groups(P>0.05).Anterior chamber angle:compared with preoperative,anterior chamber angle increased in both groups at 3 and 6 months after surgery,and the observation group was larger than the control group(P<0.05).Complications:the incidence of complications in the observation group(13.04%)was lower than 36.96%of the control group(P<0.05).Conclusion PE+GSL can effectively correct visual acuity and improve anterior chamber depth and angle in the treatment of cataract patients with ACG,with few complications.