摘要
目的:分析单切口和双切口超声乳化白内障吸除、折叠式人工晶状体植入联合小梁切除三联手术治疗青光眼合并白内障的临床效果。方法:选择2016-01/2017-02在我院眼科诊治的68例79眼闭角型青光眼合并白内障患者,将所有患者按手术方式不同分为两组(观察组和对照组),对照组仅采取单切口手术治疗,观察组则采用双切口三联手术方法进行治疗。比较两组患者术后滤泡形成情况及术前与术后的眼压和视力改变、中央前房深度和房角开放程度及并发症情况。结果:手术后1mo,观察组患者的功能型滤泡形成率为98%,明显高于对照组功能型滤泡形成率(71%),差异有统计学意义(P<0.05)。对照组与观察组术前平均眼压、最佳矫正视力、裸眼视力比较,差异无统计学意义(P>0.05)。术后,观察组平均眼压、最佳矫正视力、裸眼视力分别为12.45±3.01mmHg、0.17±0.03、0.19±0.02,与对照组比较,差异有统计学意义(P<0.05)。两组患者术后1mo中央前房深度和房角开放程度与术前相比均有增加,但观察组增加幅度显著高于对照组,组间比较差异有统计学意义(P<0.05)。对照组术后早期发生角膜水肿5眼,短暂性浅前房4眼,一过性高眼压3眼,炎性渗出3眼。观察组术后早期发生角膜水肿4眼,短暂性浅前房3眼,一过性高眼压3眼,炎性渗出2眼。均经对症治疗1wk后好转,未出现前房出血、瞳孔夹持等严重并发症。结论:临床上双切口三联手术治疗青光眼合并白内障患者获得了较好的效果,能有效地降低患者的眼内压,改善患者的最佳矫正视力和裸眼视力,增加前房深度,术后患者功能型滤泡有较高的形成率,安全可靠。
AIM： To study and analyze the clinical effect of single incision and double incision phacoemulsification, foldable intraocular lens implantation combined with trabeculectomy triple surgery in the treatment of glaucoma with cataract. METHODS. The study was from January 2016 to February 2017 in our hospital including 68 patients （79 eyes） with glaucoma and cataract. All patients were divided into two groups （observation group and control group） the control group only take single incision surgery; the observation group was taken two incision triple operation method for treatment. The follicular formation, intraocular pressure （lOP） changes, visual acuity changes, anterior chamber depth and anterior chamber open degree were compared between the two groups. RESULTS：At lmo after the surgery, functional follicular formation rate was 98% in observation group, higher than the control group （71%） with significant difference （ P〈 0. 05）. The control group and the observation group the mean preoperative lOP, best corrected visual acuity, uncorrected visual acuity had no significant difference （ P〉 0.05）. In observation group, postoperative mean lOP, best corrected visual acuity, uncorrected visual acuity was 12.45±3.01mmHg, 0.17±0.03, 0.19±0.02, significantly different compared control group （ P〈 0. 05）. Anterior chamber depth and anterior chamber open degree increased in the two groups at 1too after operation. The changes of observation group were more than control groups （P〈0.05）. In control group, there were 5 eyes with corneal edema, 4 eyes with transient shallow anterior chamber, 3 eyes with transient high lOP, 3 eyes with inflammatory exudation. In observation group, there were 4 eyes with corneal edema, 3 eyes with transient shallow anterior chamber, 3 eyes with transient high IOP, 2 eyes with inflammatory exudation. After oneweek treatment, those side reaction recovered, without hyphema, pupillary capture or other severe complications. CONCLUSION： The two incision triple surgery in the treatment of glaucoma with cataract patients get better results, effectively reduce intraocular pressure, improve the patients＇ best corrected visual acuity and uncorrected visual acuity, more formation rate of function follicular, increase the anterior chamber depth, it is safe and reliable.
出处
《国际眼科杂志》
CAS
2017年第11期2089-2092,共4页
International Eye Science
关键词
单切口
双切口
青光眼
白内障
single incision
double incisions
glaucoma
cataract
