Efficacy of Combined Phacoemulsification and Goniosynechialysis in the Treatment of Patients with Primary Angle Closure Disease and Concomitant Cataract at Preah Ang Duong Hospital in Cambodia

Background: Goniosynechialysis is a surgical procedure that has been shown to slow the progression of glaucoma in oriental eyes with chronic angle closure glaucoma. This procedure was successful in 80% of cases, and the peripheral anterior syenchiae did not exist until one year later. Nonetheless, there is little evidence of its efficacy in our context. Our study aims to investigate the efficacy of goniosynechialysis during phacoemulsification in patients with primary angle closure disease and concomitant cataract. Methods: This was an observational, prospective study. The intra-ocular pressure, need for anti-glaucoma drugs, visual acuity, the extent of synechiae, anterior chamber depth, surgical success rate, and other indicators were monitored for at least three months following surgery. Results: This study included 114 patients (118 eyes), 61 with chronic angle closure glaucoma (51.69%), 33 with primary angle closure (27.97%), and 24 with acute attack angle closure (20.34%), who were surgically treated with phacoemulsification and goniosynechialysis (Phaco-GSL). The mean intra-ocular pressure had significantly decreased three months after surgery (pre- vs post-op: 22.04 ± 10.86 vs 15.41 ± 6.06 mmHg, p-value p-value p-value p-value p-value Conclusion: Regardless of the type of glaucoma, combined phacoemulsification-goniosynechialysis is effective in lowering pressure, restoring vision, reducing the need for anti-glaucoma drugs, and preventing the synechial recurrence. Success was higher in eyes with less extensive synechiae. Phaco-GSL is safe and effective in the treatment of primary angle closure diseases with co-existing cataract.

Anterior Chamber Depth Changes in Narrow Iridocorneal Angles after Phacoemulsification

Background: The burden of cataract and glaucoma has been increasing. Primary angle closure occurs as a result of crowded anterior segment anatomy causing appositional contact between peripheral iris and trabecular meshwork. Lens extraction has been proposed as a method of deepening anterior chamber and managing intraocular pressure. Purpose: To assess changes in anterior chamber depth after phacoemulsification with intraocular lens implantation in narrow angle eyes. Design: Prospective controlled trial (before-after) study. Method: The study was conducted from March 2015 to August 2017 among the patients of department of Ophthalmology of BSMMU who were diagnosed as cataract with narrow angles. Anterior chamber angle grading of 2 or less (Shaffer grading) in 3 or more quadrants was considered narrow angle (NA). The purposive type sampling technique was applied to collect sample from the study population, as per inclusion and exclusion criteria. Complete clinical evaluation including history, physical examination, relevant ocular examinations and systemic examinations were performed. In this prospective study, subjects underwent phacoemulsification with foldable lens implantation. A scan ultrasonography was performed preoperatively and 10th and 30th postoperative days of surgery. Results: Thirty eyes of 29 patients included in the study, male: female ratio was 1:1, with an overall mean age of 62.03 ± 8.95 years. The mean preoperative central ACD was 2.95 ± 0.35 mm. At 10th and 30th POD mean central ACD were 3.94 ± 0.32, and 3.92 ± 0.28 mm respectively. Mean of increase in central ACD at final follow-up was 0.96 mm (p Conclusion: Phacoemulsification with posterior chamber in bag lens implantation can deepen the anterior chamber depth in patients with narrow angles. Based on these findings, it is concluded that phacoemulsification with foldable intraocular lens implantation is an effective tool in deepening the anterior chamber.

A Meta-Analysis: Safety and Efficacy of Phacoemulsification with Goniosynechialysis versus Trabeculectomy for Acute Angle Closure Glaucoma in China

Aim: The aim is to evaluate the safety and efficacy of phacoemulsification with goniosynechialysis versus trabeculectomy in the treatment of acute angle closure glaucoma (AACG) systematically. Methods: From January 1, 2000 to August 31, 2022, we searched PubMed, Science Citation Index Database, China National Knowledge Infrastructure, and Wanfang Database for pertinent material about the treatment of AACG with various operations. The imported literature was carefully vetted using the inclusion and exclusion criteria, assessed for quality, and the raw data were retrieved and integrated into EndNoteX9. For the meta-analysis, STATA 16.0 and RevMan 5.3 were used as the tools. Results: The meta-analysis includes 20 clinical investigations in all, involving 1463 eyes. The quality of the literature was rated as excellent and the data homogeneity among the studies was excellent based on the various study types that were included in the literature. According to a meta-analysis, phacoemulsification with goniosynechialysis is superior to trabeculectomy for treating acute angle-closure glaucoma because it results in improved postoperative visual acuity, lower intraocular pressure, a broader anterior chamber depth, and fewer complications. Conclusion: If conditions allow, phacoemulsification in conjunction with goniosynechialysis performs better than trabeculectomy in terms of visual acuity, intraocular pressure, anterior chamber depth, and comorbidities.

A Meta-Analysis: Safety and Efficacy of Phacoemulsification with Goniosynechialysis versus Trabeculectomy for Acute Angle Closure Glaucoma in China

Aim: The aim is to evaluate the safety and efficacy of phacoemulsification with goniosynechialysis versus trabeculectomy in the treatment of acute angle closure glaucoma (AACG) systematically. Methods: From January 1, 2000 to August 31, 2022, we searched PubMed, Science Citation Index Database, China National Knowledge Infrastructure, and Wanfang Database for pertinent material about the treatment of AACG with various operations. The imported literature was carefully vetted using the inclusion and exclusion criteria, assessed for quality, and the raw data were retrieved and integrated into EndNoteX9. For the meta-analysis, STATA 16.0 and RevMan 5.3 were used as the tools. Results: The meta-analysis includes 20 clinical investigations in all, involving 1463 eyes. The quality of the literature was rated as excellent and the data homogeneity among the studies was excellent based on the various study types that were included in the literature. According to a meta-analysis, phacoemulsification with goniosynechialysis is superior to trabeculectomy for treating acute angle-closure glaucoma because it results in improved postoperative visual acuity, lower intraocular pressure, a broader anterior chamber depth, and fewer complications. Conclusion: If conditions allow, phacoemulsification in conjunction with goniosynechialysis performs better than trabeculectomy in terms of visual acuity, intraocular pressure, anterior chamber depth, and comorbidities.

Endoscope-assisted goniosynechialysis combined with phacoemulsification and intraocular lens implantation to manage primary angle-closure glaucoma

AIM: To describe and evaluate a new ophthalmic endoscope surgical technique combined with phacoe-mulsification and intraocular lens (IOL) implantation to treat goniosynechialysis and manage primary angle-closure glaucoma (PACG). ·METHODS: Endoscope-assisted goniosynechialysis combined with phacoemulsification and IOL implantation was performed in 32 eyes of 29 patients with PACG. Regular follow-up was performed 1 week and 1 month, 3, and 6 months after surgery to assess complications, intraocular pressure (IOP), anterior chamber depth, visual acuity, and anterior chamber angle. ·RESULTS: Preoperative mean IOP was 24.88±7.22mmHg with pharmacological treatment, and was 13.70 ±4.02, 13.06 ±3.74, 14.29 ±4.70, and 14.33 ±5.01mmHg 1 week, 1 month, 3 months, and 6 months after surgery, respectively. The postoperative decrease in IOP was significant (P 【 0.05). The rate for all eyes with IOP of 21mmHg or less was 93.8% (30 eyes) at the final visit without ocular hypotensive agents. The average preoperative anterior chamber depth was 1.60 ±0.64mm, and this value significantly increased to 2.72±0.62, 2.76±0.70, 2.73±0.68, and 2.74 ±0.71mm at 1 week, 1 month, 3 months, and 6 months, respectively. Visual acuity was improved in 28 eyes (87.5% ) at 6 months postoperatively. The anterior chamber angle had increased in 25 eyes (78.1% ) at the final visit; it was adhesive 90°-180° in 6 eyes, 180°-270° in only 1 eye. Two eyes exhibited minimal hyphema in the early postoperative period, but it could gradually be absorbed. Fibrinous reaction was observed in five eyes and spontaneously disappeared within 7 days. No shallow anterior chamber, iridodialysis, choroidal deta-chment, or malignant glaucoma was found in any eyes.CONCLUSION:Endoscope-assisted goniosynechialysis combined with phacoemulsification and IOL implantation to manage PACG has several advantages, including optimized visualization, greater accuracy, and improved safety. Our results suggest that it has certain curative effects and clinical application value.

Angle parameter changes of phacoemulsification and combined phacotrabeculectomy for acute primary angle closure

·AIM: To evaluate the difference in angle parameters and clinical outcome following phacoemulsification and combined phacotrabeculectomy in patients with acute primary angle closure(APAC) using ultrasound biomicroscopy(UBM).·METHODS: Patients(n =23, 31 eyes) were randomized to receive phacoemulsification or combined phacotrabeculectomy(n =24, 31 eyes). Best-corrected visual acuity(BCVA), intraocular pressure(IOP), the main complications following surgery, and indentation gonioscopy and angle parameters measured using UBM were documented preoperatively and postoperatively.· RESULTS: The improvement in BCVA in the phacoemulsification group was significantly greater than in the combined group(P 【0.05). IOP in the phacoemulsification group was slightly higher than in the combined group following 1wk of follow-up(P 【0.05),whereas there was no significant difference between the two groups at the latter follow-up(P 】0.05).Phacoemulsification alone resulted in a slight increase in the trabecular ciliary processes distance compared with the combined surgery(P 【0.05), whereas the other angle parameters showed no significant difference between the groups. Complications in combined group were greater than phacoemulsification only group.·CONCLUSION: Both surgeries effectively opened the drainage angle and deepened the anterior chamber, and IOP was well controlled postoperatively. However,phacoemulsification showed better efficacy in improving visual function and showed reduced complications following surgery.

Combined treatment of phacoemulsification and single-port limited pars plana vitrectomy in acute angle-closure glaucoma

AIM: To evaluate the efficacy of combined treatment of phacoemulsification(PE) and micro-incisional single-port transconjunctival limited pars plana vitrectomy(PPV) in acute angle-closure glaucoma(AACG).METHODS: A retrospective study included 26 patients who underwent PE diagnosed with AACG. Among them, 16 patients(16 eyes) underwent PE alone, 10 patients(10 eyes) underwent combined limited vitrectomy and PE. Then we compared intraocular pressure(IOP), anterior chamber angle, anterior chamber depth, central corneal thickness and corneal endothelial cell count before and after surgery, and effective PE time during cataract surgery.RESULTS: Effective PE time was shorter in the combined surgery group than in the single surgery group(P=0.040). There was no statistically significant difference in IOP and best-corrected visual acuity between the two groups postoperatively. At 6 mo postoperatively, there was no difference in the anterior chamber angle, anterior chamber depth, and central corneal thickness between two groups, but corneal endothelial cell count was higher in the combined surgery group than in the single surgery group(P=0.046). No complication such as vitreoretinal disease, endophthalmitis, bullous keratopathy was noted.CONCLUSION: Combined micro-incisional single-port transconjunctival limited PPV and PE are more effective and safer than PE alone because of less operation time and fewer complications for management of AACG.

Phacoemulsification with or without goniosynechialysis for angle-closure glaucoma: a global Meta-analysis based on randomized controlled trials

AIM: To compare the benefits and potential harms of routine phacoemulsification(phaco) alone and combined surgery with goniosynechialysis(GSL) for angle-closure glaucoma(ACG) and coexisting lens opacity, as shown in different randomized controlled trials(RCTs).METHODS: A systematic review was conducted searching several databases including PubMed, Cochrane Library, EMBASE, ClinicalTrials.gov from the inception to September 2018 for RCTs with data published on the effects and safety of phaco and intraocular lens implantation combined with GSL or routine cataract surgery alone. Several studies were recruited which reported data at baselines and postoperative follow-up, including the mean values of postoperative intraocular pressure(IOP) and mean numbers of antiglaucoma medications using postoperatively. The numbers of complications happening were also included. Fixedeffect and random-effect models were applied, and the quality of evidence was evaluated.RESULTS: Analysis of the seven included RCTs, with a total number of 321 participants(358 eyes) diagnosed with ACG and cataract, received a solo procedure(phaco group) or a combined surgery(phaco-GSL group) randomly, and follow-up periods ranging from 2 to 12 mo postoperatively. The involved studies showed that the mean value of IOP between the two groups at 3(four studies, one study follow-up at 2 mo postoperative was included), 6, 12 mo postoperative were not significantly different. Only two studies reported the change in IOP value at 12 mo compared with baseline but showed nosignificant differences between the two interventions. Although three studies did not have the significant difference in the number of medications using to reduce IOP at 3 mo postoperatively, two studies reported that the participants using fewer anti-glaucoma medications at 12 mo postoperative in the phaco group than in the phacoGSL surgery group.CONCLUSION: The analysis provides a low to moderatequality evidence that phaco-GSL surgery lead to an equivalent IOP-lowering effect. The phaco-GSL surgery may not help patients to reduce the consumption of antiglaucoma eyedrops in the long period. The results of this analysis suggested that additional GSL may not be necessary for primary angle closure glaucoma(PACG) patients. Further studies, especially RCTs with more participants and longer follow-up time were needed to provide more sufficient data.

New Management of Angle-closure Glaucoma by Phacoemulsification with Foldable Posterior Chamber Intraocular Lens Implantation

Objective:To investigate the management of angle-closure glaucoma by phacoemulsification with foldable posterior chamber intraocular lens(PC-IOL)implantation.Design:Retrospective,noncontrolled interventional case series.Participants:In36eyes with angle-closure glaucoma(ACG),there were18eyes with primary acute angle-closure glaucoma(PACG),14eyes with primary chronic angle-closure glaucoma(PCCG),3eyes with secondary acute angle-closure glaucoma(SACG)and 1eye with secondary chronic angle-closure glaucoma(SCCG).Intervention:Phacoemulsification with posterior chamber intraocular lens implantation.Main Outcome Measures:Postoperative visual acuity,IOP,axial anterior chamber depth.Results:After a mean postoperative follow-up time of 8.81±7.45months,intraocular pressure was reduced from a preoperative mean of 23.81±17.84mmHg to a postoperative mean of 12.54±4.73mmHg(P=0.001).Mean anterior hamber depth was1.75±0.48mm preoperatively and2.29±0.38mm postoperatively(P=0.000).Best spectacle-corrected visual acuith in 36eyes ranged from0.01to0.7(20/200to20/30)postoperatively,which was better than preoperative VA ranging from hand movement to 0.4(20/50)(P=0.000).Conclusion:Phacoemulsification with posterior chamber foldable intraocular lens implantation can be a good alternative in treating angle-closure glaucoma,Eye Science 2000;16:22-28.

Phacoemulsification,Intraocular Lens Implantation,Goniosynechialysis,and Pseudo-Pupilloplasty for Refractory Acute Primary Angle Closure with Atonic Dilated Pupil

Objective To evaluate the efficacy and safety of prompt phacoemulsification,intraocular lens implantation,visco-goniosynechialysis,combined with pseudo-pupilloplasty for refractory acute primary angle closure(APAC)with atonic dilated pupil and to describe a feasible method of pupilloplasty.Methods A consecutive series of refractory APAC patients who had atonic dilated pupil and undergone prompt phacoemulsification combined with pseudo-pupilloplasty at our center were retrospectively analyzed.Pseudo-pupilloplasty referred to a method of pupilloplasty which included 4.5-mm capsulorhexis,postoperative opacification of anterior capsule residue,and ultimate pseudo-pupil formation.Preoperative and postoperative measurements included intraocular pressure(IOP),best corrected visual acuity(BCVA),and anterior chamber depth(ACD).Intraoperative and postoperative complications were documented.The process of pseudo-pupil formation was also observed.Results A total of 20 eyes of 19 APAC patients were followed up for 19.7±9.8 months.IOP was lowered from preoperative 44.0±9.8 mmHg to 15.5±2.6 mmHg at final visit(t=11.945,P<0.001).ACD was deepened from preoperative 1.77±0.21 mm to 3.40±0.20 mm at final visit(t=-27.711,P<0.001).Twelve of 20 eyes had residual angle synechiae,whereas only 3 eyes needed anti-glaucoma medications.No severe complication was observed.All eyes had pseudo-pupil gradually formed within 3 months,accompanied with the gradual improvement of BCVA from preoperative 1.18+0.55 to 0.58±0.22,0.26±0.09,0.11±0.09,and 0.11±.09 at postoperative day 1,month 1,month 3,and last visit.Conclusions Prompt phacoemulsification-goniosynechialysis is effective and safe for refractory APAC with atonic dilated pupil.Pseudo-pupilloplasty is a feasible procedure for pupil reconstruction.

Influence of Blade Outlet Angles on Separation Performance of Guide Vane Type Axial Flow Cyclone Tube

The influences of the internal and external outlet angles on separation performance and flow field are compared and analyzed. Two arc functions are employed for controlling the internal and external angles. The separation process in the cyclone tube is calculated by using two-fluid model based on the Eulerian-Eulerian method.The results show that the structure with the internal outlet angle smaller than the external one is more beneficial to the separation performance. It is found that the small internal angle can help increase the swirl number,while the small external angle can help increase the friction coefficient. Several groups of numerical simulations are conducted for the air intake unit of the gas turbine in practice. When the internal outlet angle is 35° and the external outlet angle is 40°,the blade has sufficient cyclone strength and the separation rate of particles with diameters of 10—100 μm is between70%—98%. The small blade angle is more conducive to the separation of fine particles,leading to violent collision of large particles on the outer wall and reduction of separation efficiency. In addition,reducing the external angle is conducive to the discharge of large particles.

超声乳化吸除术联合房角分离术治疗PACG滤过术后眼压失控的临床疗效观察

目的探讨超声乳化吸除术(Phaco)+人工晶状体(IOL)植入联合房角分离术治疗原发性闭角型青光眼(PACG)滤过术后眼压失控的临床疗效。方法回顾性病例研究。对2020年8月至2022年5月收治的24例(25只眼)PACG滤过术后眼压失控患者,采用Phaco+IOL植入联合房角分离术治疗,比较术前、术后1 d、1周、1个月、3个月、6个月的眼压情况,术前及6个月最佳矫正视力(BCVA)、房角粘连性关闭(PAS)范围变化情况。记录术中、术后并发症情况。结果术后1 d、1周、1个月、3个月、6个月眼压、PAS范围均显著低于术前,差异具有统计学意义(均P<0.05);术后6个月视力较术前21例(22只眼)BCVA提高,3例(3只眼)BCVA无变化;术中10只眼发生前房出血,术后6只眼发生短暂性前房出血,15只眼发生前房渗出,8只眼发生角膜水肿。结论Phaco+IOL植入联合房角分离术治疗PACG滤过术后眼压失控能够有效降低眼压,提高患者视力,是安全有效的治疗方法。

缝线引导下穿透性Schlemm管成形术联合超声乳化术治疗原发性开角型青光眼

目的:比较分析小梁切除术联合超声乳化人工晶状体植入术与缝线引导下穿透性Schlemm管成形术联合超声乳化人工晶状体植入术治疗原发性开角型青光眼(POAG)患者的临床效果。方法:回顾性病例对照研究。收集2021-06/2022-06在我院住院手术治疗的晚期POAG合并白内障患者53例53眼,其中26眼行小梁切除术联合超声乳化人工晶状体植入(A组),27眼行缝线引导下穿透性Schlemm管成形术联合超声乳化人工晶状体植入(B组)。比较两组患者手术前后最佳矫正视力(BCVA)、眼压、使用降眼压药水数量。记录术中及术后并发症、手术成功率。结果:两组患者术后1 wk, 1、3、6 mo眼压均低于术前(均P<0.017)。两组前房出血并发症比较有差异(P<0.05),浅前房和脉络膜脱离比较无差异(均P>0.05)。术后6 mo两组患者BCVA(LogMAR)比较无差异(A组:1.29±1.19,B组:0.78±1.01,P=0.098),抗青光眼药物数量比较无差异[A组:0 (0, 2.75)种,B组:0 (0, 1)种,P=0.209]。术后6 mo两组患者手术成功率比较无差异(Z=0.448,P=0.654)。结论:缝线引导下穿透性Schlemm管成形术治疗晚期原发性开角型青光眼安全有效,手术成功率与小梁切除术相当。

压力敏感涂料测量技术在掠型叶栅表面测压中的应用

为了获得某掠型叶片吸力面压力分布,对一稠度为1.53,掠角为10.7°的掠叶栅进行了光路布局以及压力敏感涂料(PSP)压力测量,利用图像处理和三维重构算法得到了可读性高、便于数据提取的三维叶片吸力面压力分布,并和测压孔测量结果进行了对比。结果表明:利用自主发展的光路布局方法,有效解决了叶片表面光照辐照度不均匀、拍摄视角受限的问题;得到了高信噪比的原始压敏图像以及宽范围多工况的掠叶栅吸力面全域压力分布。与测压孔测量相比,PSP测量误差在5%以内,并且PSP测量结果还捕捉到了峰值等熵马赫数位置沿弦向的迁移以及叶片尾缘的气流分离现象。对不同攻角和来流马赫数下的掠型叶片吸力面压力分布进行分析:掠型叶片在零攻角和正攻角下存在明显的径向压力梯度,促使后掠型叶片气流向前掠迁移,增加了前掠下流低能流体的能量,使得前掠更有利于延迟角区分离,后掠则更容易发生角区分离;掠型叶片在低来流马赫数下展向压力对称性良好,掠设计的影响不显著,高来流马赫数则放大了前后掠对角区分离控制效果的不同。相比传统测压孔有限的压力分辨率,PSP测量可为掠型叶片设计和流动机理分析提供丰富可靠的压力实验数据。

聚丙烯织物表面超亲水涂层构筑及其油水分离性能

[目的]为得到具有优秀耐久性和高油水分离效率的超亲水性聚丙烯(PP)分离材料。[方法]通过将天然来源的羧甲基纤维素(CMC)与聚丙烯织物共价结合,制备出一种具有超亲水-水下超疏油性能涂层的改性PP织物。通过扫描电镜(SEM)、红外光谱(IR)、X射线光电子能谱(XPS)等手段对改性后的样品进行分析,利用接触角测量仪和自建油水分离装置测试了改性PP织物的润湿性及油水分离性能。[结果]改性PP织物在空气中的水接触角低至0°,在水下对不同油(包括正己烷、甲苯、煤油、柴油、汽油和石油醚)的接触角都不低于150°,对油水混合物的分离效率都可达到98%以上,分离时的水通量高达69449 L/(m^(2)·h)以上。经过50次循环分离、酸碱盐溶液腐蚀浸泡8 h、砂纸刮擦30次、高含沙量水冲刷2 h等多项测试后,改性PP织物均保持优异的水下疏油性和大于97%的油水分离效率。从微观结构与化学组成的角度揭示了是表面粗糙度与亲水基团的协同作用使PP织物由最初的疏水亲油转变为超亲水-水下超疏油。[结论]通过化学键连接的方式可以在PP织物表面成功构筑牢固结合的超亲水涂层。该改性过程绿色、简便、低成本,能赋予PP织物优异、耐久的油水分离性能。改性后的PP织物有望在复杂水体环境下的油水分离场景中应用。

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

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。

晶状体超声乳化术治疗早期闭角型青光眼的效果观察

目的观察在早期闭角型青光眼治疗中使用晶状体超声乳化术所取得的治疗效果。方法选取2022年3月—2023年3月在本院接受治疗的早期闭角型青光眼患者80例为研究样本,采用随机法分两组,每组40例。采用晶状体超声乳化术治疗的作为观察组,采用周边虹膜切除治疗法的作为对照组,对比术前、后视力水平,并发症发生率,术前、后中央前房深度及眼压。结果术前,两组的视力水平对比,差异无统计学意义(P>0.05);术后,观察组的视力水平低于对照组,并发症发生率低于对照组,组间差异有统计学意义(P<0.05)。术前,两组中央前房深度及眼压对比,差异无统计学意义(P>0.05);术后,观察组中央前房深度及眼压低于对照组,组间差异有统计学意义(P<0.05)。结论在早期闭角型青光眼治疗中使用晶状体超声乳化术治疗方法,有助于改善患者视力水平,降低并发症发生率,改善中央前房深度及眼压,疾病临床治疗效果显著。

激光辅助巩膜切除及白内障摘除联合房角分离治疗闭角型青光眼

目的探究激光辅助巩膜切除及白内障摘除联合房角分离治疗闭角型青光眼的临床疗效。方法选择闭角型青光眼患者162例为研究对象,分为观察组81例行激光辅助巩膜切除及白内障摘除联合房角分离术,对照组81例行白内障摘除联合房角分离术,观察两组患者治疗效果。结果观察组患者术后视力、BCVA、房角宽度、角膜内皮细胞计数高于对照组,眼压、中央前房深度、角膜厚度均低于对照组,观察组不良反应发生率(6.2%)低于对照组(13.6%)。术后随访,两组眼压均无再升高,对照组滤过泡高度降低无观察组明显;术后1个月观察组BCVA、角膜内皮细胞计数高于对照组(P<0.05),角膜厚度低于对照组(P<0.05),术后3个月、6个月差异均无统计学意义;散光情况术后3个月观察组优于对照组,术后1个月、6个月差异无统计学意义(P>0.05)。结论激光辅助巩膜切除及白内障摘除联合房角分离术治疗闭角型青光眼临床效果好,安全性高。

高速条件下细长旋成体背风区流动特性试验研究

导弹全方向攻击时会产生由旋涡主导的复杂流动,发生转捩和流动分离,对导弹的机动性和控制能力具有重大影响。为探索攻角及马赫数对弹体流动形态的影响,针对某细长旋成体在FD-12风洞开展高速粒子图像测速及荧光油流试验,来流Ma分别为0.4、0.6、0.8,攻角范围α为0°~180°,获取了细长体背风区的流场特性演化规律。研究结果表明:当攻角α<90°时,随着攻角的增大,模型背风区流场从附着流变化为分离流,且分离涡从对称变为非对称,最终演化为非定常流动;当攻角α>90°时,情况有所不同,α=100°及α=120°时背风区存在非定常涡脱落现象,时均流场具有明显的非对称性;当攻角α=150°时,迎风面分离区出现不对称偏移,初始分离区下边界已越过模型端面,在模型中后部形成分离线;当攻角α=180°时,时均流场没有明显的特征,在模型头部位置出现了环形分离区及再附区,表明由于底部扰动的影响,该截面流场呈现局部的非定常、非线性流动状态;在攻角相同情况下,增大流场的来流Ma,不但会使分离涡的影响范围变大,也会导致分离涡的位置抬高。

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

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。