摘要
目的探讨治疗白内障伴原发性闭角型青光眼两种手术方式的适应症和初步临床疗效。方法采用临床对照研究方法,拟订手术适应症,对白内障伴原发性闭角型青光眼31例(36眼),进行手术处理,复式小梁切除联合超声乳化白内障吸除+囊袋内折叠式人工晶体植入术(Phaco Trab+IOL)和单纯超声乳化白内障吸除+晶体囊袋内折叠式人工晶体植入术(Phaco+IOL)比较不同适应症下两种手术方式初步的临床疗效,包括对比术前、术后的视力,前房深度,前房角宽度和眼压变化及并发症情况。随访10个月～12个月,结果均经统计学处理。结果两组术后在随访期内均能将眼压控制在理想范围,术后眼压较术前明显降低,Phaco Trab+IOL和Phaco+IOL组P值均<0.05,前房深度两组术后明显较术前加深P值均<0.05,差异有统计学意义,观察房角两组明显较术前加宽或重新开放,视力较术前明显提高,二组均未见严重术中并发症。结论不同手术方式适合不同的病人情况,超声乳化白内障吸除术因其具有相对加深前房和视力提高等优势可考虑作为白内障伴原发性闭角型青光眼治疗的选择性手段之一,但要注意适应症的选择。
Objective To propose the indications and preliminary clinical results of two types of surgery on treatment of cataract with primary angle-closure glaucoma.Methods The indications of two types of microsurgery were set up for a non-randomized comparison study on 36 eyes（31 cases） of cataract with primary angle-closure glaucoma,which were performed phacortrabeculectomy plus intraocular lens implantation（Phaco Trab＋IOL group） and phacoemulsification with IOL（Phaco＋IOL）.The preliminary clinical results of two groups were compared.The follow-up time was 10-12 months.Results The postoperative IOP in two groups were well controlled postoperatively compared with preoperatively（both P0.05）.The anterior chamber depth was deeper in PhacoTrab＋IOL and Phaco＋IOL group postoperativelyvs（both P0.05）;The anterior angle was widen or reopened in PhacoTrab＋IOL and Phaco＋IOL group. No sever intraoperative complications happened in two groups.The milder postoperative inflammatory response was seen in Phaco＋IOL group.Conclusions The indications of two types of microsurgery will be benefits for treatmentment on cataract with primary angleclosure glaucoma.Phaco Trab＋IOL and Phaco＋IOL group have better improvement in visual acuity,anterior chamber deepen and angle reopened,and could be considered as new alternative for cataract with primary angle-closure glaucoma.
出处
《实用防盲技术》
2011年第3期112-114,共3页
Journal of Practical Preventing Blind
