摘要
目的观察白内障超声乳化吸除、人工晶状体植入术分别联合房角分离术或小梁切除术治疗闭角型青光眼合并白内障的疗效。方法选取闭角型青光眼合并白内障患者46例(50眼),随机分为A、B两组,每组25眼。A组采用白内障超声乳化吸除、人工晶状体植入术联合房角分离术治疗;B组采用白内障超声乳化吸除、人工晶状体植入术联合小梁切除术治疗。随访1年,观察眼压、房角、并发症等。结果 A、B两组术后第12个月平均眼压分别是(17.74±3.69)和(15.16±5.01)mm Hg,两组间差异有统计学意义(t=2.07,P<0.05)。术后1个月行房角检查:A组18眼(72%)前房角全部开放,7眼(28%)残留小于45°的粘连。B组11眼(44%)于3个象限残留房角粘连,14眼(56%)残留2个象限房角粘连。A组7眼(28%),B组11眼(44%)出现并发症,两组差异无统计学意义(χ~2=1.39,P>0.05)。结论联合房角分离术对房角结构的改善效果较好,且并发症较少;联合小梁切除术控制眼压效果较好。
Objective To investigate the clinical effects of phacoemulsification combined with goniosynechialysis or trabeculectomy on angle- closure glaucoma with cataract. Methods A total of 50 eyes of primary angle- closure glaucoma with cataract were divided into group A and group B. Patients in group A were undergone phacoemulsification and IOL implantation, combined with goniosynechialysis. Patients in group B were treated with phacoemulsification and IOL implantation, combined with trabeculectomy. The changes of preoperative and postoperative anterior chamber angle figure, intraocular pressure and complications were observed and recorded. All cases were followed up for 12 months. Results The mean intraocular pressure one year after operation were(17.74±3.69) mm Hg in group A and(15.16±5.01)mm Hg in group B, and there was significant difference between them(t=2.07, P<0.05). In group A, the peripheral iris became flat after operation and anterior chamber angle widened in all eyes. Anterior chamber angle all opened in 18 eyes(72%), goniosynechia in half quadrant remained in 7 eyes(28%). In group B, goniosynechia remained in 3 quadrant in 11 eyes(44%). Goniosynechia remained in 2 quadrant in 11eyes(56%). Complications occurred in 7 eyes of group A and 11 eyes of group B, and there was significant difference between them(χ~2=1.39, P>0.05). Conclusion Goniosynechialysis has advantages of anterior chamber angle improvement and less complications; trabeculectomy has advantage of intraocular pressure reduction.
出处
《慢性病学杂志》
2016年第7期731-735,共5页
Chronic Pathematology Journal
