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Clinical Application of Cataract Ultrasonic Emulsification Combined with Atrial Angle Segmentation in the Treatment of Primary Angle-Closure Glaucoma
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作者 Xiaoxue Mei Zhishun Mao 《Journal of Clinical and Nursing Research》 2024年第7期248-254,共7页
Objective:To evaluate the therapeutic effect of cataract ultrasonic emulsification(PE)combined with atrial angle separation(CSS)for primary angle-closure glaucoma(PACG).Methods:78 patients with PACG admitted to the ho... Objective:To evaluate the therapeutic effect of cataract ultrasonic emulsification(PE)combined with atrial angle separation(CSS)for primary angle-closure glaucoma(PACG).Methods:78 patients with PACG admitted to the hospital between October 2021 and October 2023 were selected and grouped by randomized numerical table;39 cases were counted in the observation group and selected PE combined with CSS surgery;39 cases were counted in the reference group and selected PE combined with trabeculectomy and the total effective rate,the state of the atrial angle,the clinical indexes,the degree of ocular symptoms,and the complication rate were compared.Results:The total effective rate of the observation group was higher than that of the reference group,and the percentage of the wide atrial angle of the atrial angle status was higher than that of the reference group;3 months after the operation,the logarithm of the minimum angle of resolution(Log MAR)and intraocular pressure of the observation group was lower than that of the reference group,and the central anterior chamber depth(ACD)was greater than that of the reference group;the scores of the degree of ocular symptoms of the observation group were lower than that of the reference group,and the rate of complication was lower than that of the reference group(P<0.05).Conclusion:PE combined with CSS surgical treatment for PACG patients can improve the efficacy of treatment,improve the state of the patients’atrial angles,and restore the ocular function indexes.It can alleviate the ocular symptoms as soon as possible and has a high surgical safety. 展开更多
关键词 cataract ultrasonic emulsification Atrial angle segmentation Primary closed-angle glaucoma
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Phaco联合房角分离术治疗急性闭角型青光眼合并白内障患者的疗效及对视盘血流密度的影响 被引量:1
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作者 何淑艳 王红霞 +1 位作者 张迪珂 李燕利 《川北医学院学报》 CAS 2024年第6期746-750,共5页
目的:探讨白内障超声乳化吸出(Phaco)联合房角分离术治疗急性闭角型青光眼(APACG)合并白内障患者的疗效及对视盘血流密度的影响。方法:选取100例APACG合并白内障患者为研究对象,依据手术方式不同分为对照组和观察组,每组各50例。对照组... 目的:探讨白内障超声乳化吸出(Phaco)联合房角分离术治疗急性闭角型青光眼(APACG)合并白内障患者的疗效及对视盘血流密度的影响。方法:选取100例APACG合并白内障患者为研究对象,依据手术方式不同分为对照组和观察组,每组各50例。对照组患者实施Phaco+小梁切除术治疗;观察组患者实施Phaco+房角分离术治疗,随访2个月。比较两组患者术后2个月临床疗效;术前、术后7 d、术后1及2个月最佳矫正视力(BCVA);术前及术后2个月眼压、散光度、前房深度及前房角度;术前、术后1 d、术后7 d、1个月及2个月视盘及盘周血流密度;治疗及随访期间并发症发生情况。结果:观察组术后2个月临床总有效率高于对照组(96.00%vs.84.00%,P<0.05)。术后随时间推移,两组患者BCVA均上升(P<0.05),且观察组各时间点均高于对照组(P<0.05)。术后2个月,两组患者眼压均下降(P<0.05),但组间差异无统计学意义(P>0.05);散光度均上升(P<0.05),但观察组低于对照组(P<0.05);前房深度均上升,但组间差异无统计学意义(P>0.05);前房角度均上升(P<0.05),且观察组高于对照组(P<0.05)。术后1 d,两组患者视盘整体血流密度均下降(P<0.05),术后7 d开始上升(P<0.05),术后1个月与术前无统计学差异(P>0.05),术后2个月较术前升高(P<0.05),且术后各时间点观察组均高于对照组(P<0.05)。术前及术后各时间点两组盘周血流密度差异无统计学意义(P>0.05)。观察组总并发症发生率低于对照组(8.00%vs.24.00%,P<0.05)。结论:相较于Phaco+小梁切除术,Phaco联合房角分离术能进一步提升APACG合并白内障患者临床疗效,能更好改善患者术眼散光度及前房角度,提升患者视盘血流密度,且并发症较少。 展开更多
关键词 急性闭角型青光眼 白内障 超声乳化 房角分离术 视盘血流密度
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临床护理干预用于白内障合并青光眼效果观察
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作者 张婧 秦培燕 李姒珈 《中国药业》 CAS 2024年第S02期175-177,共3页
目的探讨临床护理干预在白内障合并青光眼护理中的应用效果。方法选取医院2022年12月至2023年12月收治的白内障合并青光眼患者60例,随机分为观察组和对照组,各30例。两组患者均予常规护理服务,观察组患者增加临床护理干预。结果观察组... 目的探讨临床护理干预在白内障合并青光眼护理中的应用效果。方法选取医院2022年12月至2023年12月收治的白内障合并青光眼患者60例,随机分为观察组和对照组,各30例。两组患者均予常规护理服务,观察组患者增加临床护理干预。结果观察组患者的术后复发率为0,显著低于对照组的33.33%(P<0.05)。护理后,观察组患者的眼压为(14.35±1.50)mmHg,显著低于对照组的(18.50±2.10)mmHg;视力为0.75±0.01,显著高于对照组的0.50±0.02(P<0.05)。观察组患者的住院费用、住院天数、焦虑程度、生活质量均显著优于对照组(P<0.05)。结论临床护理干预应用于白内障合并青光眼的护理可有效改善患者的眼压及视力,降低术后复发率,减少住院费用,缩短住院天数,缓解焦虑,提高生活质量。 展开更多
关键词 临床护理干预 白内障 青光眼 应用效果
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超声乳化术联合小梁切除术或房角分离术治疗青光眼合并白内障的效果
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作者 张灵波 杨鹏飞 杨培 《河南医学研究》 CAS 2024年第21期3942-3945,共4页
目的探讨超声乳化术联合小梁切除术或房角分离术治疗青光眼合并白内障的效果。方法选取2019年5月至2022年10月在平顶山市第一人民医院诊治的青光眼合并白内障患者60例,根据手术方式分为观察组(超声乳化术联合房角分离术,31例)和对照组(... 目的探讨超声乳化术联合小梁切除术或房角分离术治疗青光眼合并白内障的效果。方法选取2019年5月至2022年10月在平顶山市第一人民医院诊治的青光眼合并白内障患者60例,根据手术方式分为观察组(超声乳化术联合房角分离术,31例)和对照组(超声乳化术联合小梁切除术,29例),比较两组术后及术后1、3、6个月的视力,术前、术后6个月的眼动脉血流动力学、手术效果,以及并发症发生情况。结果与术前比较,两组术后1、3、6个月视力均升高(P<0.05);与术后1个月比较,两组术后3、6个月视力均升高(P<0.05);与对照组比较,术后1、3、6个月观察组视力更高(P<0.05)。与术前比较,术后6个月两组阻力指数(RI)均降低,收缩期峰值流速(PSV)、舒张末期流速(EDV)均升高(P<0.05);与对照组比较,术后6个月观察组RI更低,PSV、EDV更高(P<0.05)。与术前比较,术后6个月两组眼压均降低,前房角度、前房深度、散光度均升高(P<0.05);与对照组比较,术后6个月观察组眼压更低,前房角度、散光度更高(P<0.05)。观察组术后并发症发生率(9.68%)与对照组(20.69%)比较,差异无统计学意义(P>0.05)。结论超声乳化术联合房角分离术能够使得青光眼合并白内障患者收获理想的疗效,患者的视力得到显著改善,在改善眼动脉血流动力学同时提高手术效果,且不增加并发症。 展开更多
关键词 青光眼 白内障 手术效果 超声乳化手术 小梁切除术 房角分离术
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超声乳化联合房角分离术治疗白内障合并闭角型青光眼患者的效果及对术后并发症的影响
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作者 陈强 罗世华 +2 位作者 罗春红 谢冰 曾慧琪 《外科研究与新技术(中英文)》 2024年第3期219-222,共4页
目的探讨超声乳化联合房角分离术治疗白内障合并闭角型青光眼患者的临床效果以及对并发症产生的影响。方法选取2018年2月—2024年4月期间收治的白内障合并闭角型青光眼患者100例,采用随机数字表法分为对照组和观察组(各50例)。对照组治... 目的探讨超声乳化联合房角分离术治疗白内障合并闭角型青光眼患者的临床效果以及对并发症产生的影响。方法选取2018年2月—2024年4月期间收治的白内障合并闭角型青光眼患者100例,采用随机数字表法分为对照组和观察组(各50例)。对照组治疗方案为超声乳化+人工晶体植入术,观察组治疗方案为超声乳化+人工晶体植入术联合房角分离术。以治疗效果、术后并发症发生情况、生活质量改善情况作为观察指标。结果与对照组比较分析,观察组治疗总有效率较高(P<0.05)。观察组术后并发症发生率低于对照组,差异显著(P<0.05)。生活质量指标在治疗前,两组间差异无统计学意义(P>0.05),治疗后,两组生活质量指标均升高,观察组高于对照组(P<0.05)。结论超声乳化+人工晶体植入术联合房角分离术治疗白内障合并闭角型青光眼具有突出作用效果,可减少患者术后并发症发生,利于其生活质量改善,值得广泛应用于临床。 展开更多
关键词 白内障 青光眼 白内障超声乳化 房角分离术 并发症
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Outcomes of 1.8-3.0 mm incision phacoemulsification combined with trabeculectomy for primary angle-closure glaucoma with cataract 被引量:10
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作者 Qing Wang Zheng-Xuan Jiang Rong-Feng Liao 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2020年第2期246-251,共6页
●AIM:To compare efficacy of coaxial microincisions(1.8 mm,2.2 mm)and small incisions(3.0 mm)on phacoemulsification combined with trabeculectomy for primary angle-closure glaucoma(PACG)with cataract.●METHODS:Ninety-s... ●AIM:To compare efficacy of coaxial microincisions(1.8 mm,2.2 mm)and small incisions(3.0 mm)on phacoemulsification combined with trabeculectomy for primary angle-closure glaucoma(PACG)with cataract.●METHODS:Ninety-six patients(96 eyes)with PACG and cataract were recruited and randomly divided into three groups between January 2015 and June 2017.Group A(3.0 mm incision),B(2.2 mm incision),and C(1.8 mm incision)comprised 30,34 and 32 eyes respectively.All cases were treated with clear corneal incision phacoemulsification combined with trabeculectomy.Data including best corrected visual acuity(BCVA),corneal astigmatism,corneal endothelial cell counts(CECC),intraocular pressure(IOP),and complications were collected before the operation,and at postoperative 1 d,1 and 3 mo.●RESULTS:All the patients were successfully treated with surgery.The BCVA of groups B and C were significantly improved as compared to group A at postoperative 1 d,1 and 3 mo(all P<0.05),but there was no difference between groups B and C at each time interval(all P>0.05).The corneal astigmatism of group A was statistically higher than that of group B(P=0.026);corneal astigmatism of group B was statistically higher than that of group C at postoperative 1 d(P=0.006).The corneal astigmatism of group A at postoperative 3 mo was significantly higher than that before operation(P=0.003).At postoperative 1 and 3 mo,corneal astigmatism of groups B and C were significantly lower than that of group A(all P<0.05).The CECC in group B was significantly higher than that of group A(P=0.020),and CECC in group C was significantly higher than that of group B(P=0.034)at postoperative 1 d.At postoperative 1 and 3 mo,CECC of groups B and C were significantly higher than that of group A(all P<0.05).In each group,postoperative mean IOP at each time interval was significantly lower than preoperative IOP(all P<0.05).●CONCLUSION:Coaxial microincision phacoemulsification combined with trabeculectomy for PACG with cataract has better curative efficacy in reducing postoperative corneal astigmatism and corneal endothelial cell injury than traditional small incision combined surgery,and the 1.8 mm microincision has better curative efficacy than 2.2 mm microincision in the early postoperative period. 展开更多
关键词 coaxial MICROINCISION glaucoma cataract PHACOEMULSIFICATION TRABECULECTOMY
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Phacoemulsification versus combined phacotrabeculectomy in the treatment of primary angle-closure glaucoma with cataract: a Meta-analysis 被引量:17
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作者 Fang Wang Zhi-Hong Wu 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2016年第4期597-603,共7页
AIM: To compare the efficacy and safety of phacoemulsification(Phaco) against combined phacotrabeculectomy(Phacotrabe) in primary angle-closure glaucoma(PACG) with coexisting cataract.·METHODS: By searchi... AIM: To compare the efficacy and safety of phacoemulsification(Phaco) against combined phacotrabeculectomy(Phacotrabe) in primary angle-closure glaucoma(PACG) with coexisting cataract.·METHODS: By searching electronically the Pub Med,EMBASE, Scientific Citation Index and Cochrane Library published up from inception to January 2014, all randomized controlled trials that matched the predefined criteria were included. The quality of included trials was evaluated according to the guidelines developed by the cochrane collaboration. And the outcomes estimating efficacy and safety of two different surgical treatments were measured and synthesised by Rev Man 5.0.· RESULTS: Five randomized controlled trials were selected and included in Meta-analysis with a total of468 patients(468 eyes) with both PACG and cataract. We found that Phacotrabe had a greater intraocular pressure(IOP) lowing effect [preoperative IOP: weighted mean difference(WMD)=0.58, 95% confidence intervals(95% CI,-0.53 to 1.69), P =0.31; postoperative IOP: WMD =1.37,95% CI(0.45 to 2.28), P =0.003], a lower number of antiglaucoma medications [risk ratio(RR)=0.05, 95% CI(0.02 to 0.18), P 〈0.00001] needed postoperatively and less serious damage of optic nerve [RR =0.48, 95% CI(0.21 to 1.07), P =0.07], but a higher risk of complications[odds ratio(OR)=0.04, 95% CI(0.01 to 0.16), P 〈0.00001]compared with Phaco. The rest studies indicated that there had no significantly difference between the two surgical methods for postoperative best-corrected visual acuity(BCVA) [WMD =-0.05, 95% CI(-0.14 to 0.05), P =0.32] and loss of visual field [RR=1.06, 95% CI(0.61 to1.83), P =0.83].·CONCLUSION: Phaco alone compared with Phacotrabe had a better effect in IOP reduction, whereas the securitydecline. Considering the number of sample size, our results remains to be further studied. 展开更多
关键词 phacoemulsificaton phacotrabeculectomy primary angle-closure glaucoma cataract Meta-analysis
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The change of anterior segment parameters after cataract surgery in normal-tension glaucoma 被引量:3
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作者 Wonseok Lee Hyoung Won Bae +1 位作者 Chart Yun Kim Gong Je Seong 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2017年第8期1239-1245,共7页
AIM: To investigate the change of anterior chamber angle morphology and intraocular pressure (lOP) reduction after cataract surgery in patients with normal-tension glaucoma (NTG) using swept-source optical cohere... AIM: To investigate the change of anterior chamber angle morphology and intraocular pressure (lOP) reduction after cataract surgery in patients with normal-tension glaucoma (NTG) using swept-source optical coherence tomography (SS-OCT). METHODS: This prospective, comparative, observational study recruited patients into two groups. Group 1 was the control group including normal subjects except those with cataracts (cataract group, n=67 eyes of 67 patients), and group 2 was NTG group including patients who were diagnosed with NTG and cataracts (n=43 eyes of 43 patients), which were treated with phacoemulsification and intraocular lens implantation. Before surgery, and at postoperative 1 and 6too, anterior chamber angles were evaluated by SS-OCT under dark conditions using three- dimensional angle analysis scan protocol. Angle opening distance (AOD), angle recess area (ARA), and trabecular- iris surface area (TISA) at four quadrants (temporal, nasal, superior, and inferior) were calculated automatically by SS-OGT, after the observer marked scleral spurs. RESULTS: A total of 106 patients (54 males and 52 females) were enrolled in the study. Angle parameters, AOD, ARA, and TISA were increased after surgery in both groups. However, changes of angle parameters were only significant in group 2. In group 2, preoperative lOP was 13.2+2.9 mm Hg, and postoperative lOP at 1 and 6mo were 10.5+3.0 and 10.7+2.8 mm Hg, respectively. In group 1, preoperative lOP was 12.42.8 mm Hg, and postoperative lOP at 1 and 6mo were 11.6+2.5 and 12.0+2.8 mm Hg, respectively. After cataract surgery, angle parameters changed significantly while IOP significantly reduced and was maintained in group 2 (P〈0.001). The changes in angle parameters (&AOD500, ATISAS00 at temporal; &AOD500, S, RA500 at nasal) were linearly correlated with postoperative IOP changes. CONCLUSION: Cataract surgery may have improved antedor chamber angle parameters and decreased lOP in NTG patients. 展开更多
关键词 normal-tension glaucoma cataract surgery intraocular pressure reduction swept-source optical coherence tomography angle parameters
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Evaluation of the Ex-PRESS~ P-50 implant under scleral flap in combined cataract and glaucoma surgery 被引量:5
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作者 Valentín Huerva Jordi Soldevila +3 位作者 Francisco J.Ascaso Laura Lavilla M.Jesús Muniesa M.Carmen Sánchez 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2016年第4期546-550,共5页
AIM: To evaluate the efficacy and safety of glaucoma drainage device Ex-PRESS~ P-50 for combined cataract surgery and glaucoma.·METHODS: Patients having cataract and open angle glaucoma or patients with open ad... AIM: To evaluate the efficacy and safety of glaucoma drainage device Ex-PRESS~ P-50 for combined cataract surgery and glaucoma.·METHODS: Patients having cataract and open angle glaucoma or patients with open advanced glaucoma which needed two or more antiglaucoma medications were included. Combined cataract surgery and glaucoma with Ex-PRESS~ P-50 model placed under scleral flap was performed.·RESULTS: Out of 40 eyes of 40 patients(55% male and45% female) completed the study during one-year follow-up. The mean of age was 76.6 ±11.02 y. The intraocular pressure(IOP) decreased significantly during the 12-month follow-up from 23.5 mm Hg to 16.8 mm Hg(Wilcoxon signed ranks test, P 〈0.001). A 59.5% of patients did not need any topical treatment, 10.8% of them needed one active principle, 27% needed two active principles, and 2.7% of them needed three active principles for successful IOP control(〈21 mm Hg).·CONCLUSION:Combinedsurgeryofphacoemulsification with Ex PRESS~ P-50 lowers IOP from the preoperative baseline and reduces significantly the number of antiglaucoma active principles for IOP control after the operation. 展开更多
关键词 Ex PRESS combined surgery cataract surgery glaucoma surgery
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iStent inject? and cataract surgery for mild-to-moderate primary open angle glaucoma in Japan: a cost-utility analysis 被引量:2
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作者 Ataru Igarashi Kyoko Ishida +5 位作者 Nobuyuki Shoji Alice Chu Heather Falvey Ru Han Maki Ueyama Yoshie Onishi 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2022年第6期954-961,共8页
AIM: To evaluate the cost-utility of iStent inject;with cataract surgery vs cataract surgery alone in patients with mild-to-moderate primary open angle glaucoma(POAG) in the Japanese setting from a public payer’s per... AIM: To evaluate the cost-utility of iStent inject;with cataract surgery vs cataract surgery alone in patients with mild-to-moderate primary open angle glaucoma(POAG) in the Japanese setting from a public payer’s perspective.METHODS: A Markov model was adapted to estimate the cost-utility of iStent inject;plus cataract surgery vs cataract surgery alone in one eye in patients with mild-tomoderate POAG over lifetime horizon from the perspective of Japanese public payer. Japanese sources were used for patients’ characteristics, clinical data, utility, and costs whenever available. Non-Japanese data were validated by Japanese clinical experts. RESULTS: In the probabilistic base case analysis, iStent inject;with cataract surgery was found to be cost-effective compared with cataract surgery alone over a lifetime horizon when using the ¥5 000 000/quality-adjusted life year(QALY)willingness-to-pay threshold. The incremental cost-utility ratio(ICUR) was estimated to be ¥1 430 647/QALY gained and the incremental cost-utility ratio(ICER) was estimated to be ¥12 845 154/blind eye avoided. iStent inject;with cataract surgery vs cataract surgery alone was found to increase costs(¥1 025 785 vs ¥933 759, respectively) but was more effective in increasing QALYs(12.80 vs 12.74) and avoiding blinded eyes(0.133 vs 0.141). The differences in costs were mainly driven by costs of primary surgery(¥279 903 vs ¥121 349). In the scenario analysis from a societal perspective, which included caregiver burden, iStent inject;with cataract surgery was found to dominate cataract surgery alone.CONCLUSION: The iStent inject;with cataract surgery is a cost-effective strategy over cataract surgery alone from the public payer’s perspective and cost-saving from the societal perspective in patients with mild-to-moderate POAG in Japan. 展开更多
关键词 iStent inject? glaucoma cataract surgery health-economic model COST-UTILITY
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Secondary glaucoma after pediatric cataract surgery 被引量:1
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作者 Alparslan Sahin Ihsan aa +5 位作者 Abdullah Kürsat Cingü Fatih Mehmet Türkcü Harun Yüksel Muhammed Sahin Yasin inar Seyhmus Ari 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2013年第2期216-220,共5页
AIM: To determine the incidence and risk factors of secondary glaucoma after pediatric cataract surgery.METHODS: Two hundred and forty nine eyes of 148 patients underwent cataract surgery without intraocular lens (IOL... AIM: To determine the incidence and risk factors of secondary glaucoma after pediatric cataract surgery.METHODS: Two hundred and forty nine eyes of 148 patients underwent cataract surgery without intraocular lens (IOL) implantation (group 1), and 220 eyes of 129 patients underwent cataract surgery with IOL implantation (group 2) retrospectively, were evaluated between 2000 and 2011. The outcome measure was the presence or absence of post-cataract surgery glaucoma, defined as an intraocular pressure (IOP) ≥26mmHg, as measured on at least two occasions along with corneal or optic nerve changes.RESULTS: The mean follow-up periods of group 1 and 2 were (60.86 ±30.95) months (12-123 months) and (62.11±31.29) months (14-115 months) respectively. In group 1, 12 eyes of 8 patients (4.8% ) developed glaucoma. None of the patients developed glaucoma after surgery in group 2. The mean age of the patients at the cataract surgery was (2.58±0.90) months (1 month-4 months) and the average period for glaucoma development after surgery was (9.50 ±4.33) months (4-16 months) in group 1. Three of the 12 glaucomatous eyes were controlled with antiglaucomatous medication and 9 eyes underwent trabeculectomy+mitomycinC surgery.Onepatientunderwent a second trabeculectomy+mitomycin C operation for both of his eyes.CONCLUSION:The incidence of glaucoma after pediatric cataract surgery is very low in patients in whom IOL is implanted. The aphakic eyes after pediatric cataract surgery are at an increased risk for glaucoma development particularly if they underwent surgery before 4 months of age. 展开更多
关键词 intraocular lens implantation pediatric cataract secondary glaucoma
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PEI联合术中房角镜下房角分离及房角切开术治疗中晚期PACG合并白内障 被引量:1
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作者 高思佳 闻郁 +2 位作者 万茜茜 刘贺婷 陶黎明 《国际眼科杂志》 CAS 2024年第6期864-869,共6页
目的:评价超声乳化白内障吸除人工晶状体植入术(PEI)联合术中房角镜直视下房角分离术(GSL)及房角切开术(GT)治疗中晚期原发性闭角型青光眼(PACG)合并白内障的效果。方法:回顾性病例系列研究方法。收集2021-12-01/2023-03-31在安徽医科... 目的:评价超声乳化白内障吸除人工晶状体植入术(PEI)联合术中房角镜直视下房角分离术(GSL)及房角切开术(GT)治疗中晚期原发性闭角型青光眼(PACG)合并白内障的效果。方法:回顾性病例系列研究方法。收集2021-12-01/2023-03-31在安徽医科大学第二附属医院手术的中晚期PACG合并白内障患者62例65眼,根据手术方式不同分为两组:观察组30例32眼行PEI+GSL+GT,对照组32例33眼行PEI+GSL。评估两组患者术前,术后1 d, 1 wk, 1、3、6 mo眼压、最佳矫正视力(BCVA)和抗青光眼药物使用数量。术前和术后6 mo时分别评估视野、杯盘比、前房角开放范围、前房深度、RNFL平均厚度。结果:PEI+GSL+GT组术后6 mo眼压和平均眼压降幅(16.68±2.65、11.12±8.53 mmHg)与PEI+GSL组(18.71±2.51、8.32±4.17 mmHg)有显著差异(P<0.05),眼压降幅率无差异(44.57%±21.79%和35.20%±17.94%,P>0.05)。术后6 mo两组抗青光眼药物使用数量、BCVA、前房深度、房角关闭范围均较术前改善(均P<0.01),PEI+GSL+GT组术后6 mo的药物减少数量和房角开放范围均大于PEI+GSL组(P<0.05),其余指标两组间比较均无差异(均P>0.05)。两组术后6 mo的视野平均偏差、杯盘比及RNFL平均厚度较术前均无差异(均P>0.05)。PEI+GSL+GT组手术完全成功率为81%(26/32),手术条件成功率为94%(30/32);PEI+GSL组手术完全成功率为58%(19/33),手术条件成功率为76%(25/33)。两组间手术成功率均有差异(完全成功率χ^(2)=4.275,P=0.039;条件成功率χ^(2)=4.040,P=0.044)。两组患者均未见危及视力的并发症及再次手术。结论:对于中晚期原发性闭角型青光眼合并白内障患者,采用PEI+GSL+GT治疗比PEI+GSL治疗更有效。 展开更多
关键词 原发性闭角型青光眼(PACG) 白内障 房角切开术 房角分离术 微创青光眼手术 超声乳化白内障吸除人工晶状体植入(PEI) 前房角镜检查
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Efficacy of microcatheter-assisted trabeculotomy on secondary glaucoma after congenital cataract surgery 被引量:1
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作者 Wen-Jing Zhang Ying Qi +1 位作者 Xue-Tao Huang Ren-Jie Yao 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2022年第10期1604-1610,共7页
AIM: To evaluate efficacy of microcatheter-assisted trabeculotomy(MAT) in eyes with secondary glaucoma after congenital cataract surgery and explore its correlation with the different degree of trabeculotomy. METHODS:... AIM: To evaluate efficacy of microcatheter-assisted trabeculotomy(MAT) in eyes with secondary glaucoma after congenital cataract surgery and explore its correlation with the different degree of trabeculotomy. METHODS: A retrospective analysis was conducted on patients who underwent the said procedure between September 2019 and September 2020. The patients were classified into two groups according to the degree of trabeculotomy(group 1: ≤240-degree;group 2: 240–360-degree). The intraocular pressure(IOP) and antiglaucoma drugs before and after operation was collected during the 12-month follow-up. RESULTS: Totally 27 eyes of 25 patients were included: 11(40.7%) eyes in group 1 and 16(59.3%) eyes in group 2. The mean IOP of all patients was 34.67±9.18 mm Hg preoperatively and 8.74±4.32, 9.95±5.65, 14.39±5.30, 16.02±4.37, 15.82±3.28, and 16.19±3.56 mm Hg 1 d, 1 wk, 1, 3, 6, and 12 mo after surgery, respectively. In all patients, there were significant differences in IOP at each time point(F=65.614, P<0.01). In each group, IOP after surgery was lower than that before surgery(all P<0.01), but there was no difference in the rate of IOP reduction between the two groups(P=0.246). Furthermore, the amount of anti-glaucoma medications reduced to 0.30±0.67(0–2) at 12 mo from 2.63±0.49(2–3) preoperatively(P<0.01), and there was no difference between the two groups(P>0.05). At the end of follow-up, the partial success rate was 81.8% in group 1 vs 93.75% in group 2(P=0.549). Various amount of intraoperative and postoperative hyphema occurred in all eyes, which spontaneously absorbed or cleaned through paracentesis and irrigation. No other serious complications was observed.CONCLUSION: MAT can effectively reduce IOP in patients with secondary glaucoma after congenital cataract surgery with a high success rate and safety. And it can be used as the first choice for the treatment of secondary glaucoma after surgery for congenital cataracts. 展开更多
关键词 secondary glaucoma congenital cataract microcatheter-assisted trabeculotomy illuminated microcatheter intraocular pressure
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房角分离手术联合超声乳化人工晶状体植入术对白内障合并闭角型青光眼患者的临床疗效分析 被引量:3
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作者 王鸿雁 张鲲 +1 位作者 李倩 刘莹 《中国医学装备》 2024年第5期102-106,共5页
目的:探讨房角分离手术联合超声乳化人工晶状体植入术对白内障合并闭角型青光眼患者的临床疗效。方法:选取2022年1月至2023年1月间于北京康复医院就诊的198例白内障合并闭角型青光眼患者,根据治疗方法的不同将其分为对照组和观察组,每... 目的:探讨房角分离手术联合超声乳化人工晶状体植入术对白内障合并闭角型青光眼患者的临床疗效。方法:选取2022年1月至2023年1月间于北京康复医院就诊的198例白内障合并闭角型青光眼患者,根据治疗方法的不同将其分为对照组和观察组,每组99例。对照组行白内障超声乳化人工晶状体植入术联合小梁切除术;观察组行超声乳化人工晶状体植入术联合房角分离术。比较两组手术前后的临床相关指标与角膜内皮完整性、手术后3个月临床疗效,以及并发症发生情况。结果:观察组术后3个月临床疗效总有效率为95.96%,较对照组更佳,差异有统计学意义(x^(2)=4.352,P<0.05)。两组治疗后3个月视力水平均有所提高,但组间比较差异无统计学意义(P>0.05);前房深度和前房角度均有所增大,且观察组更大;眼压均有所降低,且观察组低于对照组,差异有统计学意义(t=7.654,P<0.05)。两组治疗后3个月角膜内皮细胞密度均有所减小,而观察组明显大于对照组;角膜内皮细胞平均面积与角膜中心厚度均有所增大,而观察组明显小于对照组,差异有统计学意义(t=25.233、16.608、6.698,P<0.05)。手术治疗后观察组并发症总检率为8.08%,低于对照组的19.19%,差异有统计学意义(x^(2)=5.189,P<0.05)。结论:白内障合并闭角型青光眼患者实施房角分离手术联合超声乳化人工晶体植入术疗效确切,可有效提高患者视力水平,同时也改善了前房深度、前房角度和眼压,更利于维持患者角膜内皮细胞的完整性,且安全性较好。 展开更多
关键词 白内障 闭角型青光眼 房角分离术 超声乳化人工晶状体植入术 视力
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Effect of intraocular lens implantation on visual field in glaucoma and comorbid cataracts
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作者 Can Zhao Qing Cun +6 位作者 Yi-Jin Tao Wen-Yan Yang Hua Zhong Feng-Jie Li Sean Tighe Ying-Ting Zhu Ting Wang 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2020年第4期580-586,共7页
AIM: To investigate the effects of intraocular lens(IOL) implantation on visual field(VF) in patients with glaucoma and comorbid cataracts(G&C) with different disease severities.METHODS: Totally 56 eyes of 50 pati... AIM: To investigate the effects of intraocular lens(IOL) implantation on visual field(VF) in patients with glaucoma and comorbid cataracts(G&C) with different disease severities.METHODS: Totally 56 eyes of 50 patients with primary G&C were included. All patients were divided into three groups based on the severity of the VF defect: the mild, moderate, and severe stage. Phacoemulsification was performed for cataract removal combined with IOL implantation. Visual acuity(VA) and VF tests were performed for all enrolled patients, up to 3 mo after surgery. Changes in VF threshold and global VF index in various groups were also recorded before and after surgery. The mean light sensitivity(MS) values and the changes following surgery(DMS) were compared between the three groups. Advanced Glaucoma Intervention Study(AGIS) scoring was analyzed on all VF results for analysis of changes in VF before and after surgery.RESULTS: Following surgery, the MS values of the three groups of G&C increased significantly, while the AGIS scores decreased statistically in all groups. The DMS values for the three zones in moderate and severe stage but not mild stage were statistically different between zones. The DMS value was significantly higher in zone I than those in zone II and III(zone I>zone II>zone III;P<0.05). The DMS was significantly higher in zone I than that in zone III in moderate stage patients(zone I>zone II>zone III;P<0.01), while the DMS values in the severe stage patients was significantly higher in zone I than those in zone II and III(zone I>zone II>zone III;P<0.01). CONCLUSION: The mean VF sensitivity of glaucoma patients increased significantly after cataract removal and IOL implantation. Variations in the severity and distribution of characteristics of VF defects result in differences in postoperative VF improvements after cataract surgery. The magnitude of increase in VF sensitivity is associated with VF defect characteristic in glaucoma. 展开更多
关键词 cataract INTRAOCULAR LENS visual field glaucoma
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Secondary in-the-bag intraocular lens implantation combined with 120-and 360-degree goniotomy in glaucoma following congenital cataract surgery:a case report
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作者 Yu Zhang Yue Zhou +2 位作者 Yun-He Song Xiu-Lan Zhang Wei-Rong Chen 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2023年第4期659-662,共4页
Dear Editor,Glaucoma following cataract surgery(GFCS)is one of the most sight-threatening postoperative complications of pediatric cataract surgery,and often becomes refractory to medical treatment[1].Goniotomy has be... Dear Editor,Glaucoma following cataract surgery(GFCS)is one of the most sight-threatening postoperative complications of pediatric cataract surgery,and often becomes refractory to medical treatment[1].Goniotomy has been an increasingly popular procedure for primary open angle glaucoma and primary angle-closure glaucoma with 120-. 展开更多
关键词 glaucoma surgery cataract
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普拉洛芬滴眼液对实施白内障超声乳化抽吸联合房角分离术的原发性闭角型青光眼合并白内障患者预后的影响
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作者 董娜娜 王钦 +2 位作者 魏科 纪风涛 李永蓉 《中国药物应用与监测》 CAS 2024年第5期644-647,共4页
目的 观察普拉洛芬滴眼液对实施白内障超声乳化抽吸联合房角分离术的原发性闭角型青光眼合并白内障患者预后的影响。方法 选取2022年1月至2023年12月在合肥市第二人民医院眼科予以针对性治疗的原发性闭角型青光眼伴白内障患者共103例为... 目的 观察普拉洛芬滴眼液对实施白内障超声乳化抽吸联合房角分离术的原发性闭角型青光眼合并白内障患者预后的影响。方法 选取2022年1月至2023年12月在合肥市第二人民医院眼科予以针对性治疗的原发性闭角型青光眼伴白内障患者共103例为此次试验的对象,通过随机数字表法分为两组,所有患者均予以白内障超声乳化抽吸联合房角分离术治疗,对照组52例患者术后予以重组牛碱性成纤维细胞生长因子眼用凝胶结合妥布霉素地塞米松滴眼液治疗,观察组51例患者术后加用普拉洛芬滴眼液治疗。比较两组并发症发生情况,手术后1个月的结膜充血和眼压、视功能相关生命质量量表(NEI-VFQ-25)评分和治疗满意度。结果 观察组术后并发症发生率[1.96%(1/51)]低于对照组[15.38%(8/52)],差异有统计学意义(χ^(2)=4.257,P=0.039);观察组术后NEI-VFQ-25得分、眼压和结膜充血评分[分别为(44.23±2.04)分、(15.22±1.89) mm Hg(1 mm Hg≈0.133 kPa)、(1.04±0.27)分]优于对照组[分别为(32.26±2.84)分、(18.45±2.00) mm Hg、(1.42±0.33)分],差异有统计学意义(t=24.526、8.421、6.389,均P<0.05)。在满意度方面,观察组(96.07%,49/51)相较于对照组(84.61%,44/52)更高(χ^(2)=3.859,P<0.05)。结论 原发性闭角型青光眼伴白内障患者实施白内障超声乳化抽吸联合房角分离术术后应用普拉洛芬滴眼液能够降低并发症出现概率,改善日常生活质量以及眼部压力。 展开更多
关键词 原发性闭角型青光眼 白内障 普拉洛芬滴眼液 房角分离术 白内障超声乳化抽吸 预后 并发症 视力
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A Comparative Analysis of Anxiety and Depression among Glaucoma and Cataractous Patients in Southwest Nigeria
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作者 A. C. Okudo O. E. Babalola A. T. Ogunro 《Open Journal of Ophthalmology》 2021年第2期105-133,共29页
<strong>Background:</strong> Glaucoma is the leading cause of irreversible blindness worldwide. An appreciable proportion of glaucoma patients have been found to have hidden psychiatric disorders that ofte... <strong>Background:</strong> Glaucoma is the leading cause of irreversible blindness worldwide. An appreciable proportion of glaucoma patients have been found to have hidden psychiatric disorders that often go undetected. Anxiety and depression have been found to be major contributors to these psychological issues. This present study aims to compare the prevalence of anxiety and depression amongst glaucoma and cataract patients and to identify risk factors for anxiety and depression amongst these patients. <strong>Materials and Methods:</strong> A comparative crossectional study was carried out among 197 Primary Open Angle Glaucoma (POAG) patients and 197 controls (non-POAG patients that have no ocular disorder other than cataract) attending Deseret Community Vision Institute, Ijebu Imushin, Ogun state from 1st of April to 31st May 2014. POAG was defined as patients with open anterior chamber angles based on gonioscopy, pale and cupped discs (Cup: Disc ratio ≥ 0.4), and corresponding visual field defects with or without an elevated intraocular pressure. Cataract was defined as patients with opacification of the crystalline lens in either or both eyes. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression among the participants. Data were analyzed using SPSS Version 20 using Chi-square, Independent student T-test and Logistic regression. <strong>Results:</strong> The mean age of glaucoma subjects was 62.24 years and the cataract subjects was 64.2 years. There was a male preponderance with a male: female ratio of 1.5:1. Anxiety as defined by the HADS was seen in 35.5% of glaucoma patients and 21.8% of the cataract patients but there was no statistically significant difference after controlling for sociodermographic and clinical characteristics on logistic regression. The risk factors for anxiety among the glaucoma participants were those younger than 60 (OR 2.9, 95% CI: 1.3 - 6.5 p = 0.009) and those with severe glaucoma (OR 9.5, 95% CI: 1.7 - 54.4 p = 0.011). The risk factors for anxiety among cataract patients were sociodermographic factors. Those employed (OR 6.4. 95% CI: 2.1 - 20.0 p = 0.001) and those separated and divorced (OR 10.3, 95% CI: 1.4 - 78.4 p = 0.002). Visual status was not a risk factor amongst the cataract participants. Depression as defined by HADS was seen in 24.4% of glaucoma participants and 3.6% of cataract participants. Glaucoma participants were four times more likely to be depressed than the cataract participants after controlling for clinical and sociodermographic variables (OR 4.0, 95% CI: 1.5 - 10.8 p = 0.007). The risk factors for depression among the glaucoma participants were those younger than 60 (OR 4.7, 95% CI: 1.7 - 13.5 p = 0.004), those with primary (OR 6.6, 95% CI: 1.5 - 28.4) p = 0.010) and secondary education (OR 8.0, 95% CI: 2.1 - 29.9 p = 0.002) as compared to those with tertiary education, those unemployed (OR 2.0, 95% CI: 1.0 - 7.2 p = 0.042) as compared to those employed. Those blind (OR 10.8. 95% CI: 2.8 - 42.4 p = 0.001) as compared to those without visual impairment and those that had had surgery (OR 3.7, 95% CI: 1.4 - 10.0 p = 0.011). <strong>Conclusion:</strong> Anxiety and Depression were found in 35.5% and 24.4% of glaucoma patients as compared to 21.8% and 3.6% of cataract patients respectively. Glaucoma patients were 4 times more likely to be depressed than patients with cataracts. There was no significant difference in anxiety between the two groups but glaucoma patients had a four times higher risk of being depressed as compared to cataract patients. There is a need to address these psychological issues at the community level in order to improve the quality of life of these patients. It is also important to identify those at risk in order to curb this growing trend/concern. 展开更多
关键词 ANXIETY DEPRESSION glaucoma cataract
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Case Report: Observation of Postoperative Refractive Status of Glaucoma Combined with Cataract and Irregular Astigmatism
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作者 Bin Lin Longlong Chen Dongkan Li 《International Journal of Clinical Medicine》 2023年第10期429-437,共9页
Significance: So far, many scholars have studied the astigmatism caused by glaucoma surgery, but they cannot provide enough useful help for the clinic. When a patient has glaucoma, cataracts and irregular astigmatism ... Significance: So far, many scholars have studied the astigmatism caused by glaucoma surgery, but they cannot provide enough useful help for the clinic. When a patient has glaucoma, cataracts and irregular astigmatism at the same time, it is often difficult to achieve satisfactory results. Purpose: This study intends to describe a case of a patient with glaucoma, irregular astigmatism, and cataract who was successfully treated. Additionally, it can serve as a useful source of inspiration for the future care of patients like this. Case Presentation: A 24-year-old male with keratoconus in the past. He had undergone a corneal crosslinking operation in the right eye and a penetrating keratoplasty in the left eye due to his long history of keratoconus in both eyes. Right now, the keratoconus in that eye is stable. Unfortunately, he has now been diagnosed with open-angle glaucoma and complicated cataracts in both eyes, and he was admitted to our hospital for surgery. The right eye had significant irregular astigmatism, which was discovered during the preoperative assessment, and the implantation of a Toric intraocular lens was unable to produce good results. Finally, we chose to perform EXPRESS glaucoma drainage device implantation + phacoemulsification + intraocular lense (ZEISS CT ASPHINA 409MP) implantation. The patient had stable postoperative astigmatism with rule thanks to the traction effect of the scleral flap suture. Astigmatism was typically stable six months after surgery, and the corrected visual acuity with glasses had improved to 20/25. Conclusion: This patient suffers from cataracts, keratoconus, glaucoma, and irregular astigmatism. Due to the interconnectedness of these four disorders, simultaneous success is challenging. We realized that surgically induced astigmatism, frequently affects vision early after filtering surgery for glaucoma patients. In the instance of this patient, we tightly sutured the scleral flap and using tractive action, established regular astigmatism. After the patient’s astigmatism stabilized, optometry was given to correct the vision. This technique should result in much better visual acuity. Finally, it came to pass. 展开更多
关键词 glaucoma cataract KERATOCONUS ASTIGMATISM Fltering Surgery
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Meta-analysis of the efficacy and safety of combined surgery in the management of eyes with coexisting cataract and open angle glaucoma
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作者 Nan Jiang Gui-Qiu Zhao +6 位作者 Jing Lin Li-Ting Hu Cheng-Ye Che Qian Wang Qiang Xu Cui Li Jie Zhang 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2018年第2期279-286,共8页
AIM: To conduct a systematic review and quantitative Meta-analysis of the efficacy and safety of combined surgery for the eyes with coexisting cataract and open angle glaucoma.METHODS: We performed a systematic sear... AIM: To conduct a systematic review and quantitative Meta-analysis of the efficacy and safety of combined surgery for the eyes with coexisting cataract and open angle glaucoma.METHODS: We performed a systematic search of the related literature in the Cochrane Library, PubM ed, EMBASE, Web of Science databases, CNKI, CBM and Wan Fang databases, with no limitations on language or publication date. The primary efficacy estimate was identified by weighted mean difference of the percentage of intraocular pressure reduction(IOPR%) from baseline to end-point, the percentage of number of glaucoma medications reduction from pre-to post-operation, and the secondary efficacy evaluations were performed by odds ratio(OR) and 95% confidence interval(CI) for complete and qualified success rate. Besides, ORs were applied to assess the tolerability of adverse incidents. Meta-analyses of fixed or random effect models were performed using Rev Man software 5.2 to gather the consequences. Heterogeneity was evaluated by Chi^2 test and the I^2 measure.RESULTS: Ten studies enrolling 3108 patients were included. The combined consequences indicated that both glaucoma and combined cataract and glaucoma surgery significantly decreased IOP. For deep sclerectomy vs deep sclerectomy plus phacoemulsification and canaloplasty vs phaco-canaloplasty, the differences in IOPR% were not all statistically significant while trabeculotomy was detected to gain a quantitatively greater IOPR% compared with trabeculotomy plus phacoemulsification. Furthermore, there was no statistical significance in the complete and qualified success rate, and the rates of adverse incidents for trabeculotomy vs trabeculotomy plus phacoemulsification.CONCLUSION: Compared with trabeculotomy plus phacoemulsification, trabeculectomy alone is more effective in lowering IOP and the number of glaucoma medications, while the two surgeries can not demonstrate statistical differences in the complete success rate, qualified success rate, or incidence of adverse incidents. 展开更多
关键词 open angle glaucoma cataract glaucoma surgery phacoemulsification combined surgery Meta-analysis
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