摘要
目的 :以术后视力水平、房角结构变化为评价指标,评估采用超声乳化联合小梁切除术治疗闭角型青光眼并白内障患者的整体疗效。方法 :本研究为前瞻性研究,选取2020年1月―2022年10月仙桃市第一人民医院眼科收治的82例闭角型青光眼并白内障患者为研究对象,根据手术方法不同分为对照组(n=39)、联合组(n=43),对照组闭角型青光眼并白内障患者采用单纯小梁切除术进行治疗,联合组闭角型青光眼并白内障患者采用超声乳化联合小梁切除术进行治疗。评价指标包括:手术前后视力、眼压及房角结构参数变化、术后1个月视觉质量、围术期并发症情况。结果 :在术后1个月,两组患者的视力明显升高,眼压明显降低,且与对照组相比,联合组视力明显更高,眼压明显更低。两组患者术后1个月中央前房深度、小梁虹膜角、房角开放距离均高于术前,且联合组显著高于对照组;两组患者手术前后,小梁睫状突距离比较,差异无统计学意义。根据术后1个月的看电视、看书、夜间视物、精细操作的视觉质量评测,联合组患者的评分均高于对照组评分。联合组并发症总发生率显著低于对照组。结论 :针对闭角型青光眼并白内障患者的治疗方案选择,超声乳化联合小梁切除术具有诸多优势,相比于常规的小梁切除术,它能更加有效促进患者视功能恢复,改善房角结构参数,降低围术期并发症发生率。
Objective To evaluate the overall efficacy of phacoemulsification combined with trabeculectomy in the treatment of angle-closure glaucoma and cataract using postoperative visual acuity level and changes of Angle structure as evaluation indexes.Methods In this study,82 patients with angle-closure glaucoma and cataract admitted to the ophthalmology department of the First People's Hospital of Xiantao City from January 2020 to November 2022 were selected as research objects,and divided into control group(n=39)and combination group(n=43)according to different surgical methods.Patients with angle-closure glaucoma and cataract in the control group were treated with trabeculectomy alone,and patients with angle-closure glaucoma and cataract in the combined group were treated with phacoemulsification combined with trabeculectomy.The evaluation indexes included the changes of visual acuity,intraocular pressure and angular structural parameters before and after surgery,visual quality one month after surgery,and perioperative complications.Results One month after surgery,the visual acuity of both groups was significantly increased,and the intraocular pressure of patients was significantly decreased,and compared with the control group,the combined group had significantly higher visual acuity and significantly lower intraocular pressure.The central anterior chamber depth of the two groups one month after operation,trabecular iris Angle,opening distance of room Angle were higher than before surgery,and the combination group was significantly higher than control group.Before and after operation,the distance of trabecular ciliary process was measured and compared between the two groups,the results showed no statistical significance.According to the postoperative 1 month watching TV,reading,night vision and fine manipulation,the combined group had higher scores than the control group.The total complication rate was 41.03%in the control group and 16.28%in the combination group,which was significantly lower than that in the control group.Conclusion For the treatment of angle-closure glaucoma and cataract,phacoemulsification combined with trabeculectomy has many advantages.Compared with conventional trabeculectomy,phacoemulsification combined with trabeculectomy can more effectively promote the recovery of visual function,improve the parameters of room Angle structure,and reduce the incidence of perioperative complications.
作者
李婷
胡红梅
刘含军
叶凡
LI Ting;HU Hongmei;LIU Hanjun;YE fan(Department of Ophthalmology,Xiantao First People's Hospital Affiliated to Yangtze University,Xiantao 429004,China)
出处
《湖南师范大学学报（医学版）》
2023年第2期126-129,148,共5页
Journal of Hunan Normal University(Medical Sciences)
基金
湖北省卫生健康委员会联合基金(WJ2019-62)
关键词
闭角型青光眼
白内障
超声乳化白内障吸除术
小梁切除术
视力
房角结构
angle-closure glaucoma
cataracts
phacoemulsification cataract aspiration
trabeculectomy
eyesight
angular structure
