老年青光眼合并白内障患者应用超声乳化联合小梁切除术治疗的临床效果分析

Clinical effect of phacoemulsification combined with trabeculectomy in the treatment of senile glaucoma with cataract

目的探讨老年青光眼合并白内障患者采用超声乳化联合小梁切除术治疗的临床疗效。方法84例(84只眼)老年青光眼合并白内障患者,随机分为对照组与观察组,每组42例(42只眼)。对照组患者应用小梁切除术治疗,观察组患者应用超声乳化联合小梁切除术治疗。对比两组患者术前、术后1周、术后3个月、术后6个月眼压及随访6个月并发症发生情况。结果术前、术后1周,两组患者眼压对比差异无统计学意义(P>0.05);术后3、6个月,观察组患者眼压分别为(11.67±2.89)、(12.36±2.78)mm Hg(1 mm Hg=0.133 kPa),明显低于对照组的(14.86±2.68)、(15.05±1.89)mm Hg,差异具有统计学意义(P<0.05)。随访6个月,观察组患者并发症发生率为7.14%,低于对照组的23.81%,差异有统计学意义(P<0.05)。两组患者均未出现严重并发症。结论老年青光眼合并白内障患者采用超声乳化联合小梁切除术治疗,使患者眼压得到有效改善,手术安全,临床效果显著,具有进一步推广应用的价值。

Objective To discuss the clinical efficacy of phacoemulsification combined with trabeculectomy in the treatment of senile glaucoma with cataract.Methods A total of 84 senile patients(84 eyes)with glaucoma and cataract were randomly divided into control group and observation group,with 42 cases(42 eyes)in each group.Patients in the control group were treated with trabeculectomy,and patients in the observation group were treated with phacoemulsification combined with trabeculectomy.The intraocular pressure before surgery,1 week after surgery,3 months after surgery,6 months after surgery,and complications at 6-month follow-up were compared between the two groups.Results Before surgery and 1 week after surgery,there was no statistically significant difference in intraocular pressure between the two groups(P>0.05).At 3 and 6 months after surgery,the intraocular pressures of the observation group were(11.67±2.89)and(12.36±2.78)mm Hg(1 mm Hg=0.133 kPa),which were significantly lower than(14.86±2.68)and(15.05±1.89)mm Hg of the control group,and the differences were statistically significant(P<0.05).At 6-month follow-up,the complication rate in the observation group was 7.14%,which was lower than 23.81%in the control group,and the difference was statistically significant(P<0.05).No serious complications occurred in either group.Conclusion The combined application of phacoemulsification and trabeculectomy in senile patients with glaucoma and cataract can effectively improve the intraocular pressure of patients.The operation is safe and can achieve good clinical effect,which has the value of further promotion and application.