不同手术方式治疗闭角型青光眼合并白内障的临床观察

Clinical observation of different surgical methods in the treatment of angle-closure glaucoma complicated with cataract

目的探讨不同手术方式治疗闭角型青光眼合并白内障的临床价值。方法选取2015年1月至2020年12月赣州市立医院收治的150例闭角型青光眼合并白内障患者作为研究对象,按照手术治疗方式不同分为A组、B组、C组,每组50例。A组行虹膜周边切除术,B组行虹膜周边合并小梁切除术,C组行白内障超声乳化吸除+人工晶体植入+虹膜周边切除+小梁切除术,比较3组视力变化、术后平均视敏度、眼压、前房深度及并发症发生率。结果术后6个月,3组视力均高于术前,差异有统计学意义(P<0.05),但3组间术前、术后6个月视力比较差异无统计学意义;3组术后平均视敏度比较差异有统计学意义(P<0.05),A组术后平均视敏度均高于B组、C组,且C组高于B组,差异有统计学意义(P<0.05)。术后6个月,3组眼压均高于术前,差异有统计学意义(P<0.05),但3组术前、术后6个月眼压比较差异无统计学意义。术后6个月,3组前房深度均深于术前,差异有统计学意义(P<0.05),但3组术前、术后6个月前房深度比较差异无统计学意义。3组并发症发生率比较差异无统计学意义。结论3种手术方式均能改善闭角型青光眼合并白内障患者视力、眼压、前房深度,手术安全性较高,临床可根据患者实际情况选择术式。

Objective To explore the clinical value of different surgical methods in the treatment of angle-closure glaucoma complicated with cataract.Methods 150 patients with angle-closure glaucoma and cataract treated in Ganzhou Municipal Hospital from January 2015 to December 2020 were selected as the research subjects,and they were divided into the group A,the group B and the group C according to different surgical treat-ment methods,with 50 cases in each group.The group A underwent periiridectomy,the Group B underwent periiridectomy combined with trabeculec-tomy,and the group C underwent phacoemulsification+intraocular lens implantation+periiridectomy+trabeculectomy.The changes of visual acu-ity,average postoperative visual acuity,intraocular pressure,anterior chamber depth and the incidence of complication were compared among the three groups.Results At 6 months after surgery,the visual acuity of the three groups were higher than that before surgery,the difference was statisti-cally significant(P<0.05),but there were no significant differences in the visual acuity among the three groups before surgery and 6 months after surgery;there were significant differences in the average postoperative visual acuity among the three groups(P<0.05),the average postoperative vi-sual acuity in the group A was higher than that in the group B and group C,and the group C was higher than the group B,the differences were statisti-cally significant(P<0.05).At 6 months after surgery,intraocular pressure of the three groups were higher than that before surgery,the difference was statistically significant(P<0.05),but there were no significant differences among the three groups before surgery and 6 months after surgery.At 6 months after surgery,anterior chamber depth of the three groups were deeper than that before surgery,the differences were statistically significant(P<0.05),but there were no significant differences in the anterior chamber depth among the three groups before surgery and 6 months after surgery.There were no significant differences in the incidence of complications among the three groups.Conclusion The three surgical methods can im-prove the visual acuity,intraocular pressure,and anterior chamber depth of patients with angle-closure glaucoma combined with cataract,and the sur-gical safety is high,the surgical methods can be selected according to the actual situation of patients.