小梁切除术联合超声乳化白内障吸除人工晶状体植入术治疗闭角型青光眼合并白内障患者的近期随访研究

Short-term follow-up study of trabeculectomy combined with phacoemulsification and intraocular lens implantation in the treatment of angle-closure glaucoma patients with cataract

目的研究小梁切除术联合超声乳化白内障吸除人工晶状体植入术在闭角型青光眼(ACG)合并白内障患者治疗中的应用价值。方法选取2017年2月~2019年1月我院收治的ACG合并白内障患者72例,按照手术方案不同分组,对照组(n=36)采用超声乳化白内障吸除人工晶状体植入术,观察组(n=36)采用小梁切除术联合超声乳化白内障吸除人工晶状体植入术。比较两组手术前后视力、眼压(IOP)、视野缺损情况、前房深度(ACD)、眼轴长度(AL)、并发症发生率。结果手术后1个月观察组AL(20.48±1.29)mm与对照组(20.29±1.36)mm对比无显著差异(t=0.608,P=0.545),观察组视力(0.72±0.13)高于对照组(0.50±0.16),IOP(9.28±1.35)mmHg低于对照组(12.50±1.79)mmHg,ACD(2.43±0.33)mm、视野缺损(-16.24±3.51)dB绝对值小于对照组(2.03±0.29)mm、(-14.18±3.39)dB(t=0.608、6.403、8.617、5.463、2.385,P均<0.05);与对照组并发症发生率22.22%(8/36)比较,观察组5.56%(2/36)较低(χ^(2)=4.181,P=0.041)。结论ACG合并白内障患者采用小梁切除术联合超声乳化白内障吸除人工晶状体植入效果确切,可降低眼压,加深前房,改善视野缺损,提高视力,安全性高。

Objective To study the value of application trabeculectomy and phacoemulsification and intraocular lens implantation in the treatment of patients with angle-closure glaucoma(ACG)complicated with cataract.Methods Seventy-two patients with ACG and cataract treated in our hospital from February 2017 to January 2019 were selected,they were divided into different groups according to the operation plan,the control group(n=36)used phacoemulsification cataract extraction and intraocular lens implantation,and the observation group(n=36)used trabeculectomy+phacoemulsification cataract extraction and intraocular lens implantation.Visual acuity,intraocular pressure(IOP),visual field defect,anterior chamber depth(ACD),axial length(AL),and complication rate were compared between the two groups before and after surgery.Results One month after surgery,there was no significant difference in AL between the observation group(20.48±1.29)mm and the control group(20.29±1.36)mm(t=0.608,P=0.545),and the visual acuity of the observation group(0.72±0.13)was higher than that of the control group(0.50±0.16).,IOP(9.28±1.35)mmHg was lower than the control group(12.50±1.79)mmHg,ACD(2.43±0.33)mm,visual field defect(-16.24±3.51)dB absolute value was lower than the control group(2.03±0.29)mm,(-14.18±3.39)dB(t=0.608、6.403、8.617、5.463、2.385,All P<0.05);compared with the complication rate of 22.22%(8/36)in the control group,the 5.56%(2/36)in the observation group was lower(χ^(2)=4.181,P=0.041).Conclusion Trabeculectomy+phacoemulsification and intraocular lens implantation in patients with ACG complicated with cataract are effective,and can reduce intraocular pressure,deepen the anterior chamber,improve visual field defect,improve visual acuity,and have high safety.