同轴微切口超声乳化联合小梁切除术治疗原发性闭角型青光眼合并白内障患者临床研究

Clinical Study of Coaxial Microincision Phacoemulsification Combined with Trabeculectomy in Patients with Primary Angle-Closure Glaucoma Complicated with Cataract

目的分析同轴微切口(1.8 mm)超声乳化联合小梁切除术在原发性闭角型青光眼(PACG)合并白内障患者中的作用。方法回顾性分析2020年4月—2021年4月日照市岚山区人民医院收治的80例PACG合并白内障患者的病历资料,依据治疗措施的不同把所有患者划分为对照组和观察组,每组40例。对照组行小切口(3.0 mm)超声乳化单纯小梁切除术,观察组行同轴微切口(1.8 mm)超声乳化联合小梁切除术,观察至术后3个月。对比两组眼压、中央前房深度、视力改善情况、生活质量、并发症。结果术前,两组眼压、中央前房深度、最佳矫正视力(BCVA)与生活质量综合评定问卷(GQOLI-74)内各维度评分比较,差异无统计学意义(P>0.05);术后,观察组中央前房深度、BCVA与GQOLI-74内各维度评分高于对照组,差异有统计学意义(P<0.05);但两组术后的眼压比较,差异无统计学意义(P>0.05);观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论同轴微切口超声乳化+小梁切除术治疗PACG合并白内障患者作用明显,能够显著控制眼压,调节视力,改善患者生活质量,且并发症较少,临床应用价值较高,值得临床应用。

Objective To analyze the effect of coaxial microincision(1.8 mm)phacoemulsification combined with trabeculectomy in patients with primary angle-closure glaucoma(PACG)and cataracts.Methods The medical records of 80 patients with PACG and cataract admitted to our hospital from April 2020 to April 2021 were retrospectively analyzed,and they were divided into two groups by different treatment measures.Among them,40 patients who underwent phacoemulsification simple trabeculectomy were included in the control group,and 40 patients who underwent coaxial microincision(1.8 mm)phacoemulsification combined with trabeculectomy were included in the observation group until 3 months after surgery.The two groups were compared with intraocular pressure,central anterior chamber depth,visual acuity improvement,quality of life,and complications.Results Before surgery,there were no significant differences between intraocular pressure,central anterior chamber depth,BCVA and the scores of each dimension in GQOLI-74(P>0.05);after surgery,the observation group's depth of central anterior chamber,BCVA and the scores of each dimension in GQOLI-74 were higher than control group's(P<0.05);but the comparison of two groups in intraocular pressure was no significant difference(P>0.05);the observation group's complication rate was lower than control group's(P<0.05).Conclusion Coaxial microincision phacoemulsification+trabeculectomy has obvious effect in the treatment of patients with PACG combined with cataracts,which can significantly control eye pressure,regulate vision,improve quality of life,and have fewer complications,high clinical application value,and worthy of vigorous application.