小梁切除术+超声乳化白内障吸除术+人工晶状体植入术治疗白内障合并慢性闭角型青光眼的临床效果

Clinical effect of trabeculectomy + ultrasonic phacoemulsification + intraocular lens implantation in the treatment of cataract complicated with chronic angle-closure glaucoma

目的分析小梁切除术+超声乳化白内障吸除术+人工晶状体植入术治疗白内障合并慢性闭角型青光眼的临床效果。方法选择2018年4月至2021年4月于我院进行诊治的90例白内障合并慢性闭角型青光眼患者,按照电脑盲选法将其分为对照组(超声乳化白内障吸除术+人工晶状体植入术)与研究组(小梁切除术+超声乳化白内障吸除术+人工晶状体植入术),每组45例。比较两组的治疗效果。结果术后3个月,研究组的视力高于对照组,眼压低于对照组,前房深度、前房角度大于对照组(P<0.05)。术后3 d,研究组的白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-17(IL-17)及肿瘤坏死因子-α(TNF-α)水平低于对照组(P<0.05)。术后3个月,研究组的眼动脉舒张末期血流速度(EDV)、收缩期峰值血流速度(PSV)高于对照组,阻力指数(RI)低于对照组(P<0.05)。两组的并发症总发生率比较,差异无统计学意义(P>0.05)。结论小梁切除术+超声乳化白内障吸除术+人工晶状体植入术治疗白内障合并慢性闭角型青光眼的临床效果显著。

Objective To analyze the clinical effect of trabeculectomy+ultrasonic phacoemulsification+intraocular lens implantation in the treatment of cataract complicated with chronic angle-closure glaucoma.Methods A total of 90 patients with cataract complicated with chronic angle-closure glaucoma who were diagnosed and treated in our hospital from April 2018 to April 2021 were selected,and divided into control group(ultrasonic phacoemulsification+intraocular lens implantation)and study group(trabeculectomy+ultrasonic phacoemulsification+intraocular lens implantation)according to the computer blind selection method,with 45 cases in each group.The therapeutic effects of the two groups were compared.Results At 3 months after operation,the visual acuity of the study group was higher than that of the control group,the intraocular pressure was lower than that of the control group,and the anterior chamber depth and anterior chamber angle were greater than those of the control group(P<0.05).At 3 d after operation,the levels of interleukin-6(IL-6),interleukin-8(IL-8),interleukin-17(IL-17)and tumor necrosis factor-α(TNF-α)in the study group were lower than those in the control group(P<0.05).At 3 months after operation,the end diastolic velocity(EDV)and peak systolic velocity(PSV)of ophthalmic artery in the study group were higher than those in the control group,the resistance index(RI)was lower than that in the control group(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion The trabeculectomy+ultrasonic phacoemulsification+intraocular lens implantation in the treatment of cataract complicated with chronic angle-closure glaucoma has a significant clinical effect.