| 摘要: |
| ［摘要］ 目的 分析双切口小梁切除联合超声乳化人工晶状体植入术治疗原发性闭角型青光眼合并白内障的临床效果。方法 回顾性分析2017年8月至2019年8月因原发性青光眼合并白内障在该院行手术治疗的112例患者的临床资料，根据手术方法不同分为观察组62例（67眼）和对照组50例（54眼），观察组实施双切口白内障超声乳化吸除+非球面人工晶状体置入+小梁切除联合手术；对照组实施同切口白内障超声乳化吸除+非球面人工晶状体置入+小梁切除联合手术。比较两组患者术前、术后6个月视力与眼压（最佳矫正视力、眼压值）、中央前房深度与房角开放度数、角膜内皮细胞平均面积与密度、术后滤过泡形成情况以及并发症发生情况。结果 术后6个月，两组患者最佳矫正视力均较术前提高（P<0.05），眼压均较术前降低（P<0.05），但两组术后比较差异无统计学意义（P>0.05）。两组患者中央前房深度和房角开放度数均较术前提高（P<0.05），且观察组高于对照组（P<0.05）。两组患者角膜内皮细胞平均面积均较术前增加，且观察组高于对照组；密度均较术前降低，且观察组低于对照组，差异均有统计学意义（P<0.05）。观察组患者功能型滤过泡形成率显著高于对照组（P<0.05）。两组术后并发症发生率比较差异无统计学意义（P>0.05）。结论 小梁切除联合超声乳化人工晶状体植入手术治疗原发性青光眼合并白内障的同切口、双切口术式均安全有效，但双切口术式可减少角膜内皮细胞损失，更有利于术后功能型滤过泡的形成。 |
| 关键词: 双切口 白内障超声乳化吸除 非球面人工晶状体置入 小梁切除术 原发性闭角型青光眼 白内障 角膜内皮细胞 |
| DOI：10.3969/j.issn.1674-3806.2021.09.15 |
| 分类号:R 779.66 |
| 基金项目: |
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| Efficacy analysis of double-incision trabeculectomy combined with phacoemulsification and intraocular lens implantation in treatment of primary angle-closure glaucoma with cataract |
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LIU Xi
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Zhengzhou Central Hospital Affiliated to Zhengzhou University, Henan 450000, China
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| Abstract: |
| ［Abstract］ Objective To analyze the clinical effects of double-incision trabeculectomy combined with phacoemulsification and intraocular lens implantation on treatment of primary angle-closure glaucoma with cataract. Methods The clinical data of 112 patients undergoing surgical treatment in Zhengzhou Central Hospital Affiliated to Zhengzhou University due to primary glaucoma with cataract from August 2017 to August 2019 were retrospectively analyzed. The patients were divided into observation group(62 cases, 67 eyes) and control group(50 cases, 54 eyes) according to different surgical methods. The observation group was given combined surgery of double-incision phacoemulsification+aspheric intraocular lens implantation+trabeculectomy. The control group was given combined surgery of same incision phacoemulsification+aspheric intraocular lens implantation+trabeculectomy. The visual acuity and intraocular pressure(best corrected visual acuity, intraocular pressure value), central anterior chamber depth and angle opening degree, average area and density of corneal endothelial cells, postoperative filtering bleb formation and the occurrence of complications were compared between the two groups before surgery and 6 months after surgery. Results Compared with those before surgery, the best corrected visual acuity was significantly improved(P<0.05), while the intraocular pressure was significantly decreased(P<0.05) in the two groups 6 months after surgery, but there were no significant differences between the two groups after surgery(P>0.05). Compared with those before surgery, the central anterior chamber depth and angle opening degree in the two groups were significantly higher(P<0.05), and the two indexes in the observation group were significantly higher than those in the control group(P<0.05). Compared with those before surgery, the average areas of corneal endothelial cells in the two groups were increased, and the area of the observation group was significantly larger than that of the control group. Compared with those before surgery, the densities in the two groups were decreased, and the density of the observation group was significantly lower than that of the control group(P<0.05). The functional filtering bleb formation rate in the observation group was significantly higher than that in the control group(P<0.05), and there was no statistically significant difference in the incidence of postoperative complications between the two groups(P>0.05). Conclusion Both the same incision and double-incision procedures of trabeculectomy combined with phacoemulsification and intraocular lens implantation are safe and effective for treatment of primary glaucoma with cataract. However, double-incision surgery can reduce the loss of corneal endothelial cells and is more conducive to the formation of postoperative functional filtering bleb. |
| Key words: Double incisions Phacoemulsification Aspheric intraocular lens implantation Trabeculectomy Primary angle-closure glaucoma Cataract Corneal endothelial cells |
