内镜下睫状体光凝联合超声乳化人工晶状体植入术治疗闭角型青光眼合并白内障的临床研究

Clinical Study of Endoscopic Ciliary Body Photocoagulation Combined with Phacoemulsification Intraocular Lens Implantation for the Treatment of Angle Closure Glaucoma with Cataract

目的:分析内镜下睫状体光凝联合超声乳化人工晶状体植入术在闭角型青光眼(ACG)合并白内障患者中的治疗效果。方法:选取2021年3月—2023年3月泰安八十八医院收治的82例ACG合并白内障患者,按随机数表法分为两组,各41例。对照组行房角粘连分离术联合超声乳化人工晶状体植入术治疗,观察组行内镜下睫状体光凝术联合超声乳化人工晶状体植入术治疗,术后随访3个月。比较两组视力、眼压、中央前房深度、生活质量及并发症发生率。结果:术前,两组最佳矫正视力(BCVA)、眼压、中央前房深度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3个月,观察组BCVA、中央前房深度高于对照组,眼压低于对照组,GQOLI-74评分高于对照组,差异有统计学意义(P<0.05);两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论:内镜下睫状体光凝联合超声乳化人工晶状体植入术能够改善ACG合并白内障患者视力,降低眼压,提升中央前方深度,改善生活质量,且无严重并发症。

Objective:To analyze the effect of endoscopic ciliary body photocoagulation combined with phacoemulsification intraocular lens implantation in patients with angle closure glaucoma(ACG)complicated with cataract.Method:A total of 82 patients with ACG complicated with cataract admitted to Tai’an 88 Hospital from March 2021 to March 2023 were selected and divided into two groups according to random number table method,with 41 cases in each group.The control group was treated with atrial angle adhesion separation combined with phacoemulsification intraocular lens implantation,the observation group was treated with endoscopic ciliary body photocoag-ulation+phacoemulsification intraocular lens implantation,and the postoperative follow-up was 3 months.The visual acuity,intraocular pressure,central anterior chamber depth,quality of life and complication rate were compared between the two groups.Result:Before surgery,there were no significant differences in the scores of best corrected visual acuity(BCVA),intraocular pressure,central anterior chamber depth and generic quality of life inventory-74(GQOLI-74)between the two groups(P>0.05).Three months after surgery,BCVA and central anterior chamber depth in observation group were higher than those in control group,intraocular pressure was lower than that in control group,and GQOLI-74 scores were higher than those in control group,the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion:Endoscopic ciliary body photocoagulation combined with phacoemulsification intraocular lens implantation can improve the vision of ACG patients with cataract,reduce the intraocular pressure,increase the central anterior depth,and improve the quality of life without serious complications.