不同手术治疗方式对青光眼合并白内障患者视力眼压散光度及并发症的影响
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摘要
目的:比较白内障超声乳化(Phaco)联合小梁切除术与Phaco联合房角分离术治疗对青光眼合并白内障患者视力、眼压、散光度及并发症的影响。方法:收集2016年3月至2018年3月我院收治的青光眼合并白内障患者94例,其中49例行Phaco联合小梁切除术(小梁切除术组),45例行Phaco联合房角分离术(房角分离术组),比较两组术后6个月视力改善情况、术眼眼压、前房深度、前房角度、散光度及并发症情况。结果:术后6个月,两组视力提高率比较(77.55%vs84.44%)无统计学差异(P>0.05)。术后6个月,两组术眼眼压降低程度及前房深度增加程度均无统计学差异(P>0.05);但房角分离术组前房角度增加明显大于小梁切除术组(P<0.05)。术后6个月,房角分离术组散光度增加程度及并发症发生率均明显低于小梁切除术组(P<0.05)。结论:与Phaco联合小梁切除术相比,Phaco联合房角分离术治疗青光眼合并白内障术后散光度低,且并发症少。
Objective: To compare the effects of phacoemulsification (Phaco) combined with trabeculectomy and Phaco combined with goniosynechialysis on vision,intraocular pressure,astigmatism and complications in patients with glaucoma complicated with cataract. Methods: 94 patients with glaucoma and cataract admitted in our hospital from March 2016 to March 2018 were collected. Among them,49 patients were treated with Phaco combined with trabeculectomy (trabeculectomy group),45 patients were treated with Phaco combined goniosynechialysis (goniosynechialysis group). The vision improvement,intraocular pressure,anterior chamber depth,anterior chamber angle,astigmatism and complications in the two groups 6 months after surgery were compared. Results: At 6 months after operation,there was no significant difference in visual acuity improvement rate between the two groups (77.55% vs 84.44%) (P >0.05). At 6 months after operation,there was no significant difference in the decrease degree of intraocular pressure and increase degree of anterior chamber depth between the two groups (P >0.05). However,the increase of anterior chamber angle in the goniosynechialysis group was significantly greater than that in the trabeculectomy group (P <0.05). At 6 months after operation,the increase degree of astigmatism and the incidence of complications in the goniosynechialysis group were significantly lower tha those in the trabeculectomy group (P <0.05). Conclusion: Compared with Phaco combined with trabeculectomy,Phaco combined with angle separation has lower astigmatism and fewer complications in the treatment of glaucoma combined with cataract.
Objective: To compare the effects of phacoemulsification (Phaco) combined with trabeculectomy and Phaco combined with goniosynechialysis on vision,intraocular pressure,astigmatism and complications in patients with glaucoma complicated with cataract. Methods: 94 patients with glaucoma and cataract admitted in our hospital from March 2016 to March 2018 were collected. Among them,49 patients were treated with Phaco combined with trabeculectomy (trabeculectomy group),45 patients were treated with Phaco combined goniosynechialysis (goniosynechialysis group). The vision improvement,intraocular pressure,anterior chamber depth,anterior chamber angle,astigmatism and complications in the two groups 6 months after surgery were compared. Results: At 6 months after operation,there was no significant difference in visual acuity improvement rate between the two groups (77.55% vs 84.44%) (P >0.05). At 6 months after operation,there was no significant difference in the decrease degree of intraocular pressure and increase degree of anterior chamber depth between the two groups (P >0.05). However,the increase of anterior chamber angle in the goniosynechialysis group was significantly greater than that in the trabeculectomy group (P <0.05). At 6 months after operation,the increase degree of astigmatism and the incidence of complications in the goniosynechialysis group were significantly lower tha those in the trabeculectomy group (P <0.05). Conclusion: Compared with Phaco combined with trabeculectomy,Phaco combined with angle separation has lower astigmatism and fewer complications in the treatment of glaucoma combined with cataract.
引文
[1]曾益群,欧阳君.超声乳化联合小梁切除术治疗青光眼合并白内障患者的眼压视力及并发症分析[J].河北医学,2016,22(10):1635~1638.
[2]戴兵,颜超.不同手术方式治疗青光眼合并白内障临床疗效比较[J].中华实验眼科杂志,2017,35(5):467~468.
[3]杨文慧,韩琪,陈松,等.超声乳化白内障吸除术对小梁切除术后原发性闭角型青光眼患者眼压的影响[J].中华眼科杂志,2016,52(2):104~109.
[4]张洪洋,余敏斌,顿中军.白内障超声乳化术与超声乳化联合小梁切除术治疗原发性闭角型青光眼Meta分析[J].中华实验眼科杂志,2013,31(3):270~274.
[5]罗丹,温跃春,季青山.小梁切除术分别联合Ologen植入与丝裂霉素C治疗青光眼的有效性和安全性对比分析[J].眼科新进展,2016,36(2):175~177.
[6]郑露,刘凯波,梁艳.超声乳化联合人工晶状体植入联合房角分离术治疗慢性闭角型青光眼[J].基因组学与应用生物学,2018,37(1):192~198.
[7]Kameda T,Inoue T,Inatani M,et al.Long-term efficacy of goniosynechialysis combined with;phacoemulsification for primary angle closure[J].Graefes Arch Clin Exp Ophthalmology,2013,251(3):825~830.
[8]代志强,王保君,杨华,等.巩膜瓣可调整缝线的小梁切除术对角膜散光的影响[J].眼科新进展,2017,37(9):882~885.
[2]戴兵,颜超.不同手术方式治疗青光眼合并白内障临床疗效比较[J].中华实验眼科杂志,2017,35(5):467~468.
[3]杨文慧,韩琪,陈松,等.超声乳化白内障吸除术对小梁切除术后原发性闭角型青光眼患者眼压的影响[J].中华眼科杂志,2016,52(2):104~109.
[4]张洪洋,余敏斌,顿中军.白内障超声乳化术与超声乳化联合小梁切除术治疗原发性闭角型青光眼Meta分析[J].中华实验眼科杂志,2013,31(3):270~274.
[5]罗丹,温跃春,季青山.小梁切除术分别联合Ologen植入与丝裂霉素C治疗青光眼的有效性和安全性对比分析[J].眼科新进展,2016,36(2):175~177.
[6]郑露,刘凯波,梁艳.超声乳化联合人工晶状体植入联合房角分离术治疗慢性闭角型青光眼[J].基因组学与应用生物学,2018,37(1):192~198.
[7]Kameda T,Inoue T,Inatani M,et al.Long-term efficacy of goniosynechialysis combined with;phacoemulsification for primary angle closure[J].Graefes Arch Clin Exp Ophthalmology,2013,251(3):825~830.
[8]代志强,王保君,杨华,等.巩膜瓣可调整缝线的小梁切除术对角膜散光的影响[J].眼科新进展,2017,37(9):882~885.