摘要
目的观察两种不同手术方式联合房角粘连分离术治疗急性闭角型青光眼合并白内障的临床效果。方法 80例急性闭角型青光眼合并白内障患者,房角关闭范围均在1/2～3/4象限,随机分为超声乳化联合房角分离术组(Phaco组)40只眼和超声乳化小梁切除联合房角分离术组(PhacoTrab组)40只眼,观察术前、术后视力、眼压、前房深度和房角变化情况,并进行统计学处理。结果术后所有患者视力均有不同程度提高,两组视力差异无统计学意义;6个月时眼压Phaco组为(15.96±3.97)mmHg(1mmHg=0.133kPa),PhacoTrab组为(16.20±4.61)mmHg,两组比较差异无统计学意义;前房深度均较术前加深,Phaco组为(3.40±0.30)mm,PhacoTrab组为(3.51±0.26)mm;前房角较术前增宽,Phaco组32只眼(80%)房角全周开放,PhacoTrab组30只眼(75%)房角全周开放,差异无统计学意义。结论超声乳化白内障吸除联合房角分离术能够有效提高视力,降低眼压,加深前房并开放房角,是治疗急性闭角型青光眼合并白内障,房角关闭1/2～3/4象限患者的一种安全有效的手术方法 。
Objective To evaluate the therapeutic effects of two different surgical methods combined with gonio- synechialysis on acute primary angle-closure glaucoma （APACG） combined with cataract. Methods Eighty cases of APACG combined with cataract with chamber angles closed 1/2 -2/3 of area were divided into Phacoemulsication combined with goniosynechialysis group （Phaco group, 40 cases） and Phacoemulsication and trabeculectomy combined with goniosynechialysis group （Phaco Trap group, 40 cases）. The changes of visual acuity, intraocular pressure（ IOP）, anterior chamber depth and the anterior chamber angle were measured before and after the operation. Results Visual acuity of all cases increased with varied degrees. There was no marked difference of the visual acuity between the two groups. The IOP was （15.96±3.97） mm Hg（ 1 mm Hg =0. 133 kPa） 6 months alter the surgery in Phaco group, while （16.20 ± 4.61 ） mm Hg in Phaco Trap group. There were no significant differences of the lOP between the two groups before and after the surgery. The anterior chamber depth was （3.40± 0.30） mm in Phace group, while （3.51 ± 0.26 ）mm in Phaco Trab group. The anterior chamber angles were opened. The ratio of complete reopened anterior chamber angle after the surgery in Phaeo group was 80% （32/40）, while the ratio in Phaco Trap group was 75% （30/40）. Conclusions Combined Phacoemulsication and goniosynechialysis could improve visual acuity, and reduce IOP effectively, deepen the an- terior chamber depth significantly and make the anterior chamber angle open. It might be a safe and effective approach for patients with APACG, combined with cataract and chamber angles closed 1/2 - 3/4 of area.
出处
《中国眼耳鼻喉科杂志》
2010年第3期171-173,共3页
Chinese Journal of Ophthalmology and Otorhinolaryngology
