摘要
目的观察改良青白联合手术治疗合并白内障的原发性慢性闭角型青光眼的临床疗效及安全性。方法回顾分析2012年9月至2013年3月在北京同仁医院眼科就诊的合并老年性白内障的原发性慢性闭角型青光眼患者50例（60只眼）。行透明角膜切口超声乳化白内障摘除折叠式人工晶状体植入联合复合式小梁切除术（50例，60只眼），随访时间6个月。主要观察指标包括眼压控制情况，手术前后用药情况，最佳矫正视力，中央前房深度和前房角等。结果术后6个月眼压较术前均下降，差异有统计学意义（P〈0．05）。术前全身或局部用降眼压药物平均（4．50±0．82）种，术后6月平均（0．23±0．57）种；术后用降眼压药物均较术前减少。34只眼（56．7％）术后3月最佳矫正视力提高，22只眼（36．7％）最佳矫正视力〉0．5，差异有显著统计学意义（P〈0．05）。手术前前房深度为（1．69±0．362）mm，术后3个月时前房深度（3．19±0．50）mm，手术前后比较差异有显著统计学意义（t=-12．669，P=0．00）。术后PAS较术前减少34只眼，术后PAS范围无明显变化者10只眼。结论以患者的房角粘连范围、用药情况结合最佳矫正视力等参数为根据制定的青光眼白内障联合手术分组标准是正确的；联合手术在降低眼压的同时还能提高视力，而且可以有效减少并发症的发生。
Objective To observe the clinical effect of combined surgery in primary chronic an- gle closure glaucoma with cataract. Methods Retrospective study was performed in 50 cases （60 eyes） of primary chronic angle-closure glaucoma patients with cataract treated with phacoemulsifica- tion combined with trabeculectomy with MMC and transconjuctiva adjustable suture. Results Preoper- ative and postoperative IOP were 23.62±l.91mmHg, 13.56±2.49mmHg （P 〈0.01）. There were 50 eyes with no medications postoperatively, there were 4 eyes with 2 medications postoperatively, there were 6 eyes with 1 medications postoperatively. The best corrected visual acuity （BCVA） of 34 eyes （56.7%） increased postoperatively compared with that preoperatively, 22 eyes 〉0.5 （36.7%）, 26 eyes （43.3%） did not increase. Preoperative, postoperative CAC depth is 1.69±0.362mm and 3.19±0.50mm. PAS：PAS of 34 eyes decreased postoperatively compared with that preoperatively, 10 eyes did not de- crease. Conclusions Combined surgery is effective and safe methods in treatment of primary chronic angle-closure glaucoma with cataract. Dividing methods according to PAS, medications, the best cor- rected visual acuity and other parameters were correct. Combined surgery not only can control IOP and improve the best corrected visual acuity, but also can decrease the occurrence of comnlications.
作者
朱伟
王涛
Zhu Wei Wang Tao(Bejing Daxing District Hospital, Beijing 102600, China Beijing Tongren Hospital Affiliated Capital Medical University, Beijing 100730, China)
出处
《中国实用眼科杂志》
2017年第1期68-72,共5页
Chinese Journal of Practical Ophthalmology
