激光辅助巩膜切除及白内障摘除联合房角分离治疗闭角型青光眼

Laser assisted sclerectomy and cataract extraction combined with angle separation in the treatment of angle closure glaucoma

目的探究激光辅助巩膜切除及白内障摘除联合房角分离治疗闭角型青光眼的临床疗效。方法选择闭角型青光眼患者162例为研究对象,分为观察组81例行激光辅助巩膜切除及白内障摘除联合房角分离术,对照组81例行白内障摘除联合房角分离术,观察两组患者治疗效果。结果观察组患者术后视力、BCVA、房角宽度、角膜内皮细胞计数高于对照组,眼压、中央前房深度、角膜厚度均低于对照组,观察组不良反应发生率(6.2%)低于对照组(13.6%)。术后随访,两组眼压均无再升高,对照组滤过泡高度降低无观察组明显;术后1个月观察组BCVA、角膜内皮细胞计数高于对照组(P<0.05),角膜厚度低于对照组(P<0.05),术后3个月、6个月差异均无统计学意义;散光情况术后3个月观察组优于对照组,术后1个月、6个月差异无统计学意义(P>0.05)。结论激光辅助巩膜切除及白内障摘除联合房角分离术治疗闭角型青光眼临床效果好,安全性高。

Objective To explore the clinical efficacy of laser⁃assisted sclerectomy and cataract extraction combined with angle separation in the treatment of angle⁃closure glaucoma.Methods A total of 162 patients with angle closure glaucoma were selected as the research subjects.Eighty⁃one patients in the experimental group under⁃went laser⁃assisted sclerectomy and cataract extraction combined with angle separation,and another 81 patients in the control group underwent cataract extraction combined with angle separation.The therapeutic effects of two groups of patients were observed.Results The postoperative visual acuity,BCVA,angle width,and corneal endothelial cell count of the experimental group were higher than those of the control group,but the intraocular pressure,central anterior chamber depth,and corneal thickness were all lower than those in the control group.The incidence of adverse reactions in the experimental group(6.2%)was lower than that in the control group(13.6%).During postop⁃erative follow⁃up,there was no further increase in intraocular pressure in the two groups,while the height of filtering blebs in the control group decreased significantly when compared with that in the experimental group.One month after surgery,the BCVA and corneal endothelial cell count in the experimental group were higher than those in the control group(P<0.05),and the corneal thickness was lower than that in the control group(P<0.05),but no statistical significance was found at 3 and 6 months after surgery.The astigmatism in the experimental group was better than that in the control group 3 months after surgery,but there was no statistically significant difference at 1 month and 6 months after surgery.Conclusion Laser⁃assisted sclerectomy and cataract extraction combined with angle separa⁃tion are effective and safe in the treatment of angle closure glaucoma.