摘要
目的观察超声乳化白内障联合房角分离术(简称超乳联合房角分离)对原发性闭角型青光眼合并白内障的治疗效果。方法根据房角粘连情况将238例患眼分为A组(房角粘连关闭≤180°)72眼,随机分为2亚组,分别采用超声乳化白内障吸除术(简称单纯超乳)、超乳联合房角分离;B组(180°<房角粘连关闭≤270°)106眼,C组(房角粘连关闭>270°)60眼,均随机分为2亚组,分别采用超声乳化白内障联合小梁切除术(简称三联)、超乳联合房角分离。术前及术后1年随访视力、眼压、裂隙灯、眼底、房角、视野并进行统计学分析。结果视力,238眼中14眼视力无变化或下降,超乳联合房角分离中仅2眼视力无提高,无1例视力下降。眼压,A组,房角分离组眼压明显低于单纯超乳亚组(P<0.01),不同时相之间眼压无差别(P>0.05);B组,房角分离亚组与三联亚组眼压存在差别(P<0.05),不同时相之间眼压存在差别(P<0.01),1个月后趋于稳定,房角分离亚组低于三联亚组;C组,房角分离亚组平均眼压稍低于三联亚组眼压,差异无统计学意义(P>0.05)。房角变化,房角分离的119眼术后1月房角镜及超生生物显微镜检查房角均不同程度开放;对照组术后部分患者房角重新开放。房角分离患者视野,A组、B组术后视野平均光敏度(mean sensitivity,MS)较术前显著性增高(P<0.01),视野指数(meandefect,MD)较术前下降,差异有统计学意义(P<0.05);C组术后MS较术前有下降趋势,MD较术前提高,但差异均无统计学意义(P>0.05)。结论对于原发性闭角型青光眼合并白内障患者,房角粘连关闭≤180°者,仅行单纯超乳就可控制眼压;180°<房角粘连关闭≤270°,超乳合并房角分离优于三联;房角粘连关闭>270°的患者,超乳合并房角分离与三联眼压控制无差异。
Objective To observe clinical effect of phacoemulsification with goniosynechialysis for angle - closure glaucoma with cateract. Methods According to the adhesion of the angle cases was divided into group A （angle adhesion closed ≤ 180 °） of 72 eyes which were randomly divided into two subgroups, respectively, using phacoemulsification, phacoemulsification with goniosynechialysis; group B （180 ° 〈angle adhesion closed 4270 °） of 106 eyes and group C （angle adhesion closed 〉 270 °）of 60 eyes which were both randomly divided into two surgical groups, respectively, using triple procedure, phacoemulsification with goniosynechialysis. Results Fourteen of 238 eyes＇ visual acuity unchanged or decreased, only two eyes＇ vision unchanged and no ease decreased after phacoemulsifieation with goniosynechialysis. Intraocular pressure （IOP） of goniosyneehialysis group was significantly lower than phacoemulsification group in group A （ P 〈 0.01 ）, IOP had no difference between the ditterent time （P 〉 0.05 ）. In group B, IOP between goniosynechialysis and triple procedure were different （ P 〈 0.05 ）, there was difference between the different time （ P 〈 0.01 ） , IOP of goniosynechialysis group was lower than triple procedure and IOP was stable after one month. In group C, the mean lOP of goniosynechialysis group was slightly less than that of triple procedure group . Difference was not statistically Significant （ P 〉 0.05 ）. Angle was open to varying degrees in 119 eyes after goniosynechialysis at one month. Angle were re - open in some patients of control group, visual field, The postoperative mean sensitivity （MS） of group A and group B significantly increased compared with preoperative level （ P 〈 0. 01 ）, visual field index（mean defect,MD）absolutely decreased compared with preoperative MD （ P 〈 0.05）. Compared with the preoperative level MS had a downward trend and MD increased in group C, but both were not significant （ P 〉 0.05）. Conclusi
出处
《河北医科大学学报》
CAS
2010年第12期1454-1457,共4页
Journal of Hebei Medical University
基金
河北省科技计划项目(092061114D)
关键词
青光眼
闭角型
白内障
治疗
glaucoma, angle - closure
cataract
THERAPY
