摘要
目的探讨白内障小切口囊外摘除人工晶体植入联合房角分离术对原发性闭角型青光眼合并有白内障患者治疗的临床效果和安全性。方法选取收治的原发性闭角型青光眼（PACG）合并白内障的患者67例（73眼），随机分为小切口白内障囊外摘除组（SICS组）和小梁切除手术组（TRAB组）。观察手术前后视力、前房深度、房角及眼压的变化情况并进行统计学处理。术后随访6个月。结果SICS组术后视力明显提高，TRAB组提高不明显。SCIS组6个月时由术前眼压（45．1±9．5）mmHg（1mmHg=0．133kPa）降低为（16．7±4．1）mmHg；TRAB组由术前（48．3±7．5）mmHg降低为（16．6±5．1）mmHg；两组手术前后比较差异均有统计学意义；SCIS组前房深度由术前（1．6±0．3）mm加深为（3．4±0．4）mm，房角关闭度数由术前（290±25）度减少到（60±35）度，手术前后比较差异有统计学意义（P〈0．05）；而TRAB组前房深度由术前（1．6±0．4）加深为（1．7±0．5）mm，房角关闭度数由术前（295±35）度减少到（285±35）度，手术前后比较差异无统计学意义（P〉0．05）。结论白内障小切口囊外摘除人工晶体植入联合房角分离术能够显著的增加前房深度，开发房角，有效地降低眼压，提高患者视功能等优势，是治疗原发性闭角型青光眼合并白内障患者的一种安全有效的手术方法。
Objective To observe and assess the efficacy and safety of treatment for patients with primary angle-closure glaucoma with the combined surgeries of small incision extracapsular cataract extraction surgery, intraoeular lens implantation and goniosynechialysis. Methods Seventy-three eyes of 67consecutive patients with primary angle-closure glaucoma and cataract were ranomized into SICS group and TRAB group. The changes of visual acuity anterior chamber depth （ACD） , extent of PAS, anterior chamber angle and IOP before and after operation were measured. The follow-up period were 6 months. Results The visual acutity was improved significiantly after and no significiantly difference in TRAB group; The IOP significiantly decreased from （45.1 ± 9. 5）ram Hg（ 1 mm Hg = 0. 133 kPa） to（ 16. 7 ± 4. 1 ）mm Hg at 6 months after surgery in SICS group. While in TRAB group, the IOP decreased from （48.3 ±7.5）ram Hg to （16.6±5.1）mm Hg. There were signifieiantly differences in two groups before and after surgery. The anterior chamber depth （ACD） was increased from （1.6 ± 0. 3 ）mm before surgery to （3.4 ± 0.4 ）mm at 3 months after surgery in SICS group, but no significiant, difference in TRAB group. The angle clousure decreased from （290 ± 25 ） befor surgery to （60 ± 35 ） at 3 months after surgery in S[CS group, the angle clousure decreased from （295 ±35 ）before surgery to （285 ± 35 ）at 3 months after surgery in TRAB group, there was signifieiantly difference in SICS group but no significiant difference in TRAB group. Conclusions Small incision extracapsular cataract extraction surgery, intraoeular lens implantation and goniosynechialysis can deepen the anterior chamber depth significantly, make the anterior chamber angle open, reduce IOP effectively, improve the patients＇ visual acuity. It is a safe and effective approach to patients with PACG and cataract.
出处
《中国实用医刊》
2012年第4期12-14,共3页
Chinese Journal of Practical Medicine
关键词
原发性闭角型青光眼
白内障
房角分离
小梁切除
Primary angle-closure glaucoma
Cataract
Goniosynechialysis
Trabeculeetomy
