摘要: |
分析双切口三联手术治疗原发性闭角型青光眼合并白内障的临床效果。方法 纳入2017年8月~2019年8月因原发性青光眼合并白内障在我院行手术治疗的112例患者的临床资料,根据手术方法不同进行分组,其中62例(67眼)实施双切口白内障超声乳化吸除+非球面人工晶状体置入+小梁切除术三联手术,纳入观察组,50例(54眼)实施单切口白内障超声乳化吸除+非球面人工晶状体置入+小梁切除术三联手术,纳入对照组。比较两组患者术前、术后3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,以及术后滤过泡形成情况、并发症发生情况。结果 术后6个月,两组患者裸眼视力、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),但两组术后差异无统计学意义(P>0.05);两组患者中央前房深度与房角开放度数均较术前提高(P<0.05),且观察组均高于对照组(P<0.05);两组患者角膜内皮细胞平均面积均较术前增加,但观察组低于对照组,密度均较术前降低,但观察组高于对照组,差异均有统计学意义(P<0.05);观察组患者功能型滤泡形成率高于对照组(P<0.05),两组术后并发症发生率差异无统计学意义(P>0.05)。结论 三联手术治疗原发性青光眼合并白内障的单切口、双切口术式均安全且有效,但双切口三联术式可减少角膜内皮细胞损失,更有利于术后功能型滤泡的形成。 |
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: |
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基金项目: |
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Clinical study of double-incision triple surgery on primary angle-closure glaucoma with cataract |
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Zhengzhou Central Hospital affiliated to Zhengzhou University
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Abstract: |
To analyze the clinical effects of double-incision triple surgery on primary angle-closure glaucoma with cataract. Methods The clinical data of 112 patients undergoing surgical treatment in our hospital due to primary glaucoma with cataract from August 2017 to August 2019 were included for retrospective analysis. The patients were grouped according to different surgical methods, of which 62 cases (67 eyes) were given triple surgery of double-incision phacoemulsification + aspheric intraocular lens implantation + trabeculectomy and were included in observation group, and 50 cases (54 eyes) were given triple surgery of single-incision phacoemulsification + aspheric intraocular lens implantation + trabeculectomy and were included in control group. The visual acuity and intraocular pressure (best corrected visual acuity, intraocular pressure value), central anterior chamber depth and angle opening degree, average area and average density of corneal endothelial cells, postoperative filtering bleb formation and occurrence of complications were compared between the two groups before surgery and at 3 months after surgery. Results At 6 months after surgery, the uncorrected visual acuity and best corrected visual acuity in the two groups were improved compared with those before surgery (P<0.05) while the intraocular pressure was decreased compared with that before surgery (P<0.05), but there were no statistical difference between the two groups after surgery (P>0.05). The central anterior chamber depth and angle opening degree in the two groups were higher than those before surgery (P<0.05), and the two indexes in observation group were higher than those in control group (P<0.05). The average area of corneal endothelial cells in the two groups was increased compared with that before surgery, but the area in observation group was lower than that in control group, and the average density was decreased compared with that before surgery, but the density in observation group was higher than that in control group (P<0.05). The functional filtering bleb formation rate in observation group was higher than that in control group (P<0.05), and there were no statistically significant differences in the incidence rates of postoperative complications between the two groups (P>0.05). Conclusion Single-incision and double-incision procedures for triple surgery of primary glaucoma with cataract both are safe and effective. However, double-incision triple surgery can reduce the loss of corneal endothelial cells and is more conducive to the formation of postoperative functional filtering bleb. |
Key words: Double-incision Phacoemulsification Aspheric intraocular lens implantation Trabeculectomy Primary angle-closure glaucoma Cataract Corneal endothelial cells |