超声乳化吸除联合房角分离术治疗白内障合并急性原发性闭角型青光眼患者的效果

Effects of phacoemulsification combined with angle separation in treatment of cataract patients with acute primary angle-closure glaucoma

目的:观察超声乳化吸除联合房角分离术治疗白内障合并急性原发性闭角型青光眼患者的效果。方法:选取2021年9月至2023年9月黔东南五州眼科医院收治的100例白内障合并急性原发性闭角型青光眼患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各50例。观察组采用超声乳化吸除联合房角分离术治疗,对照组采用超声乳化吸除联合小梁切除术治疗,两组术后均随访3个月。比较两组临床疗效,手术前后眼压水平、矫正视力水平、眼科指标(中央前房深度、小梁虹膜角、小梁睫状体距离)水平、术后不同时间(术后1周和术后1、3个月)角膜内皮细胞丢失率,以及并发症发生率。结果:观察组治疗总有效率为96.00%(48/50),高于对照组的78.00%(39/50),差异有统计学意义(P<0.05);术后,观察组眼压水平低于对照组,矫正视力水平高于对照组,差异均有统计学意义(P<0.05);术后,观察组中央前房深度、小梁虹膜角、小梁睫状体距离均大于对照组,差异有统计学意义(P<0.05);术后1周和术后1、3个月,观察组角膜内皮细胞丢失率均低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为6.00%(3/50),低于对照组的22.00%(11/50),差异有统计学意义(P<0.05)。结论:超声乳化吸除联合房角分离术治疗白内障合并急性原发性闭角型青光眼患者可提高治疗总有效率、矫正视力水平和眼科指标水平,降低眼压水平、角膜内皮细胞丢失率和并发症发生率,效果优于超声乳化吸除联合小梁切除术治疗。

Objective:To observe effects of phacoemulsification combined with angle separation in treatment of cataract patients with acute primary angle-closure glaucoma.Methods:From September 2021 to September 2023,100 patients with cataract and acute primary angle-closure glaucoma admitted to Qiandongnan Wuzhou Eye Hospital Were Selected for the prospective study.According to the random number table method,they were divided into control group and observation group,50 cases in each group.The observation group was treated with phacoemulsification combined with angle separation,while the control group was treated with phacoemulsification combined with trabeculectomy.Both groups were followed up for 3 months.The clinical efficacy,the intraocular pressure level,the corrected visual acuity level,the ophthalmic index(central anterior chamber depth,trabecular iris angle,trabecular ciliary body distance)levels before and after the surgery,the corneal endothelial cell loss rate at different time after the surgery(1 week after the surgery,1 month and 3 months after the surgery),and the incidence of complications were compared between the two groups.Results:The total effective rate of the observation group was 96.00%(48/50),which was higher than 78.00%(39/50)of the control group,and the difference was statistically significant(P<0.05).After the surgery,the intraocular pressure level of the observation group was lower than that of the control group,the corrected visual acuity level was higher than that of the control group,and the differences were statistically significant(P<0.05).After the surgery,the central anterior chamber depth,trabecular iris angle and trabecular ciliary body distance in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).1 week,1 month and 3 months after the surgery,the corneal endothelial cells loss rates in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of complications in the observation group was 6.00%(3/50),which was lower than 22.00%(11/50)in the control group,and the difference was statistically significant(P<0.05).Conclusions:Phacoemulsification combined with angle separation in the treatment of the cataract patients with acute primary angle-closure glaucoma can improve the total effective rate,the corrected visual acuity levels and the ophthalmic index levels,and reduce the intraocular pressure levels,the corneal endothelial cell loss rates and the incidence of complications.Moreover,it is superior to phacoemulsification combined with trabeculec tomy.