原发性闭角型青光眼并白内障手术治疗效果

The effect of surgical treatmeut on primarg angle closure glaucomc anel cata ract

目的:探讨治疗原发性闭角型青光眼伴白内障两种手术方式的适应症、临床疗效及预后。方法:采用非随机临床对照研究方法,拟定手术适应症,对原发性闭角型青光眼伴白内障30眼(27例),进行手术治疗,采用单纯超声乳化白内障吸除+晶体囊内折叠人工晶体植入术(Phaco+IOL)和青-白联合手术(复式小梁切除联合超声乳化白内障吸除+晶体囊内折叠人工晶体植入术(PhacoTrab+IOL),比较不同适应症下两种手术方式初步的临床疗效,随访8～15个月。结果:两组术后随访期内均能将眼压控制在理想范围,术后眼压较术前明显降低,P值<0.05;大部分患者房角较术前增宽,视野增大,前房深度明显加深,二组均未见严重术中并发症。结论:不同手术方式适合不同的病人情况,Phaco+IOL是一种可选用的安全有效的手术方法,能有效提高视力与降低眼压,无术中和术后严重并发症发生;PhacoTrab+IOL则需要患者的眼压情况控制良好,掌握手术时机,操作相对复杂,难度相对较大,但也能取得较好的临床疗效和预后。两种术式的选用要注意适应症的选择。

Objective To compare the effeets of two types of surgery on treatment of primary angle-closure glaucoma with cataract. Methods The indications of two types of microsurgery were set up for non-randomized comparison study on 30eyes ( 27cases ) of primary angle-closure glaucoma with cataract patients, who were per-formed phacoemulsification with IOL (Phaco+IOL) and phacortrabeculectomy plus intraocular lens implantation (Phaco Trab+IOL group). The preliminary clinical results of two groups were compared. The follow up visit time was 8~15 months. Results The postoperative IOP in two groups were well controlled postoperatively compared with preoperatively (both P<0.05). The chamber angle was widened and the visual field was increased in most pa-tients of the two groups. No severe intraoperative complications happened in two groups. Conclusion The indica-tions of two types of microsurgery will be benefits for treatment on primary angle-closure glaucoma.with cataract. Phacoemulsification combined with artificial lens implantation for angle-closure glaucoma is safe and effective, which can improve visual acuity and decrease intraocular pressure without inducing severe complications intra and post operation. The glaucoma cataract combined surgery demand the patients have a good condition in the in-traocular pressure and the perfect suitable surgery opportunity, and more the surgery is more complex and hard, but it has good clinical therapeutic effects&prognosis also. The two types of microsurgery must be adopted to in-dications.