[1]麦圣龙,姚金玉,吴小燕.晶状体超声乳化联合房角分离术治疗原发性闭角型青光眼合并白内障患者的临床疗效及安全性[J].眼科新进展,2021,41(3):259-262.[doi:10.13389/j.cnki.rao.2021.0054]
　MAI Shenglong,YAO Jinyu,WU Xiaoyan.Clinical efficacy and safety of phacoemulsification combined with angle separation in the treatment of primary angle-closure glaucoma with cataract[J].Recent Advances in Ophthalmology,2021,41(3):259-262.[doi:10.13389/j.cnki.rao.2021.0054]
点击复制

晶状体超声乳化联合房角分离术治疗原发性闭角型青光眼合并白内障患者的临床疗效及安全性/HTML
分享到：

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
41卷
期数:
2021年3期
页码:
259-262
栏目:
应用研究
出版日期:
2021-03-05

文章信息/Info

Title:
Clinical efficacy and safety of phacoemulsification combined with angle separation in the treatment of primary angle-closure glaucoma with cataract
作者:
麦圣龙; 姚金玉; 吴小燕
570000　海南省儋州市，海南爱尔新希望眼科医院综合眼科
Author(s):
MAI Shenglong; YAO Jinyu; WU Xiaoyan
Department of Comprehensive Ophthalmology，Hainan Aier New Hope Eye Hospital，Danzhou 570000，Hainan Province，China
关键词:
晶状体超声乳化; 房角分离术; 青光眼; 白内障; 临床疗效
Keywords:
phacoemulsification of the lens;  angular separation;  glaucoma;  cataract;  clinical efficacy
分类号:
R775
DOI:
10.13389/j.cnki.rao.2021.0054
文献标志码:
A
摘要:
目的　探讨晶状体超声乳化联合房角分离术治疗原发性闭角型青光眼（PACG）合并白内障患者的临床疗效及安全性。方法　回顾性分析2016年1月至2018年12月海南爱尔新希望眼科医院收治的70例（70眼）PACG合并白内障患者的临床资料。将32例（32眼）行晶状体超声乳化联合房角分离术治疗的患者纳入观察组，另38例（38眼）行晶状体超声乳化联合小梁切除术治疗的患者纳入对照组。对比分析两组患者术前及术后12个月术眼前房深度、前房角度、眼压及散光度，比较两组患者视力改善及并发症发生情况。结果　两组患者年龄、性别构成，术前散光度、眼压、白内障核硬度分级及裸眼视力比较，差异均无统计学意义（均为P>0.05）。术后12个月两组患者术眼前房深度、前房角度、散光度均大于术前，眼压均低于术前，差异均有统计学意义（均为P<0.05）。术后12个月观察组和对照组患者术眼前房深度及眼压比较，差异均无统计学意义（均为P>0.05）；术后12个月，观察组患者术眼前房角度明显大于对照组，而散光度明显小于对照组，差异均有统计学意义（均为P<0.001）。术后12个月，观察组视力提高27眼、视力不变4眼、视力下降1眼，对照组分别为29眼、6眼、3眼；观察组视力提高率为84.38%，对照组为76.32%，两组视力提高率差异无统计学意义（χ2=0.291，P=0.589）。术后12个月内，观察组出现角膜水肿2眼、前房渗出1眼，对照组出现角膜水肿4眼、前房渗出1眼、前房积血3眼、浅前房2眼、黄斑水肿1眼，观察组并发症发生率（9.38%）明显低于对照组（28.95%），差异有统计学意义（χ2=4.159，P=0.042）。结论　晶状体超声乳化联合房角分离术治疗PACG合并白内障可有效控制患者眼压，改善视力，且临床较为安全。
Abstract:
Objective　To explore the clinical efficacy and safety of phacoemulsification combined with angle separation in the treatment of primary angle-closure glaucoma (PACG) with cataract.Methods　A retrospective analysis was performed on the clinical data of 70 cases (70 eyes) of PACG patients with cataracts admitted to Hainan Aier New Hope Eye Hospital from January 2016 to December 2018. Thirty-two patients (32 eyes) who underwent phacoemulsification combined with angle separation were included in the observation group, and another 38 patients (38 eyes) who underwent phacoemulsification combined with trabeculectomy were included in the control group. The anterior chamber depth, anterior chamber angle, intraocular pressure and astigmatism of the two groups of patients before and 12 months after the operation were compared and analyzed, and the visual acuity improvement and complications of the two groups were compared.Results　There were no statistically significant differences in age, gender composition, preoperative astigmatism, intraocular pressure, cataract nucleus hardness classification, and naked visual acuity between the two groups (all P>0.05). Twelve months after the operation, the anterior chamber depth, anterior chamber angle, and astigmatism of the two groups of patients were greater than those before the operation, and the intraocular pressure was lower than that before the operation, and the differences were statistically significant (all P<0.05). Twelve months after surgery, there were no significant differences in the depth of the anterior chamber and intraocular pressure between the observation group and the control group (both P>0.05). Twelve months after operation, the anterior chamber angle of the observation group was significantly larger than that of the control group, while the astigmatism was significantly smaller than that of the control group. The differences were statistically significant (all P<0.001). Twelve months after the operation, the visual acuity of the observation group improved by 27 eyes, remained unchanged in 4 eyes, and decreased in 1 eye, while, in the control group, 29 eyes, 6 eyes, and 3 eyes, respectively. The visual acuity improvement rate of the observation group was 84.38%, and the control group was 76.32%, and there was no statistically significant difference in visual acuity improvement between the two groups (χ2=0.291, P=0.589). Within 12 months after the operation, the observation group had corneal edema in 2 eyes and anterior chamber effusion in 1 eye, and the control group had corneal edema in 4 eyes, anterior chamber effusion in 1 eye, anterior chamber hemorrhage in 3 eyes, shallow anterior chamber in 2 eyes, and macular edema in one eye. The incidence of complications in the observation group (9.38%) was significantly lower than that in the control group (28.95%), and the difference was statistically significant (χ2=4.159, P=0.042).Conclusion　Lens ultrasonography combined with angle separation in the treatment of PACG combined with cataract can effectively control the intraocular pressure of patients, and they can improve vision, and they are clinically more effective.

参考文献/References:

［1］　WANG Q，JIANG Z X，LIAO R F.Outcomes of 1.8-3.0 mm incision phacoemulsification combined with trabeculectomy for primary angle-closure glaucoma with cataract［J］.Int J Ophthalmol,2020,11(2):741-746.
［2］　周吉利,姚娜.超声乳化联合房角分离术治疗闭角型青光眼合并白内障的临床效果及对术后眼压的影响［J］.临床医学研究与实践,2019,4(17)：257-258.
ZHOU J L,YAO N.The clinical effect of phacoemulsification combined with angle separation in the treatment of angle-closure glaucoma with cataract and its influence on postoperative intraocular pressure［J］.Clin Med Res Pract,2019,4(17):257-258.
［3］　HANSAPINYO L，CHOY B N K，LAI J S M，THAM C C.Phacoemulsification versus phacotrabeculectomy in primary angle-closure glaucoma with cataract:long-term clinical outcomes［J］.J Glaucoma,2021,30(1):e23-e24.
［4］　VIDYA C,PUJA P,KALYANI V K,MADAN D,RAJIV K.Comparative clinical study of medically controlled nonsevere chronic primary angle-closure glaucoma with coexisting cataract surgically managed by phacoemulsification as against combined phacotrabeculectomy［J］.Middle East Afr J Ophthalmol,2018,25(3-4):119-125.
［5］　李建军,徐亮,王亚星,刘丽娟,王爽,杨桦.青光眼视神经损害的远程筛查标准［J］.眼科,2015，11(3):152-152.
LI J J,XU L,WANG Y X,LIU L J,WANG S,YANG H.Remote screening criteria for optic nerve damage in glaucoma［J］.Ophthalmol CHN,2015,11(3):152-152.
［6］　邢卫敏.不同手术方式对原发性闭角型青光眼合并白内障患者视力恢复及眼压的影响［J］.实用防盲技术,2020,11(3):523-527.
XING W M.The effect of different surgical methods on vision recovery and intraocular pressure in patients with primary angle-closure glaucoma combined with cataract［J］.J Pract Prev Blind,2020,11(3):523-527.
［7］　刘晓庆.两种手术方式治疗原发性闭角型青光眼合并白内障的临床疗效比较［J］.临床眼科杂志,2019,13(4)：416-417.
LIU X Q.Comparison of the clinical efficacy of two surgical methods in the treatment of primary angle-closure glaucoma with cataract［J］.J Clin Ophthalmol,2019,13(4):416-417.
［8］　周凌丽.白内障超声乳化术治疗原发性青光眼对患者眼压水平和视神经功能的影响［J］.中国药物与临床,2019,19(4):637-639.
ZHOU L L.The effect of phacoemulsification of cataract on the level of intraocular pressure and optic nerve function in patients with primary glaucoma［J］.Chin Med Clin,2019,19(4):637-639.
［9］　赵燕,常英霞,熊朝晖,赵延涛,王国强,秘金华.三联手术治疗闭角型青光眼合并白内障疗效分析［J］.河北医药,2019,41(14):2126-2129.
ZHAO Y,CHANG Y X,XIONG Z H,ZHA Y T,WANG G Q,MI J H.Analysis of the efficacy of triple surgery in the treatment of angle-closure glaucoma with cataract［J］.Hebei Med,2019,41(14):2126-2129.
［10］　杨晓,刘娟.超声乳化术联合前房角分离术治疗青光眼合并白内障的临床疗效分析［J］.检验医学与临床,2020,17(6):823-825.
YANG X,LIU J.Analysis of the clinical efficacy of phacoemulsification combined with anterior chamber angle separation in the treatment of glaucoma with cataract［J］.Laborat Med Clin,2020,17(6):823-825.
［11］　张伽雨,彭娜,李磊.超乳联合房角分离或小梁切除对PACG合并白内障患者血流动力学的影响［J］.国际眼科杂志,2019,19(5):51-54.
ZHANG J Y,PENG N,LI L.The effect of superemulsification combined with angle separation or trabeculectomy on hemodynamics in PACG patients with cataract［J］.Int Eye Sci,2019,19(05):51-54.
［12］　赵作亚.急性闭角型青光眼合并白内障手术治疗的临床疗效观察［J］.世界最新医学信息文摘,2019，11(19):86.
ZHAO Z Y.Observation on the clinical efficacy of surgical treatment of acute angle-closure glaucoma combined with cataract［J］.World Latest Med Inform,2019,11(19):86.
［13］　YUEN N S Y,CHAN O C C,HUI S P,CHING R H Y.Combined phacoemulsification and nonpenetrating deep sclerectomy in the treatment of chronic angle-closure glaucoma with cataract［J］.Eur J Ophthalmol,2007,17(2):208-215.
［14］　赵春梅,赵军梅.超声乳化联合房角分离术治疗原发性闭角型青光眼合并白内障的临床效果［J］.中国实用医刊,2020,47(12):58-61.
ZHAO C M,ZHAO J M.The clinical effect of phacoemulsification combined with angle separation in the treatment of primary angle-closure glaucoma with cataract［J］.Chin Pract Med J,2020,47(12):58-61.
［15］　贺新,刘宁.不同手术治疗方式对青光眼合并白内障患者视力眼压散光度及并发症的影响［J］.河北医学,2019,25(3)：555-559.
HE X,LIU N.The influence of different surgical treatments on visual acuity and intraocular pressure astigmatism and complications in patients with glaucoma and cataract［J］.Hebei Med,2019,25(3):555-559.

相似文献/References:

[1]李成钢 陈年均.超声乳化联合房角分离术治疗闭角型青光眼合并白内障的临床疗效[J].眼科新进展,2013,33(2):000.
[2]梁永强.超声乳化联合房角分离术与小梁切除术治疗原发性闭角型青光眼的疗效比较[J].眼科新进展,2013,33(2):000.
[3]苟文军,杨旭,方晏红,等. 超声乳化联合小梁切除术或房角分离术治疗合并白内障的慢性原发性闭角型青光眼[J].眼科新进展,2015,35(9):884.[doi:10.13389/j.cnki.rao.2015.0242]
　GOU Wen-Jun,YANG Xu,FANG Yan-Hong,et al. Phacoemulsification with trabeculectomy or goniosyn-echialysis for chronic primary angle-closure glaucoma with cataract[J].Recent Advances in Ophthalmology,2015,35(3):884.[doi:10.13389/j.cnki.rao.2015.0242]
[4]胡宏阁,王钰清.超声乳化白内障吸出人工晶状体植入术联合房角分离术治疗闭角型青光眼合并年龄相关性白内障的疗效观察[J].眼科新进展,2016,36(6):569.[doi:10.13389/j.cnki.rao.2016.0151]
　HU Hong-Ge,WANG Yu-Qing.Phacoemulsification and intraocular lens implantation combined with goniosynechialysis for angle-closure glaucoma with age-related cataract[J].Recent Advances in Ophthalmology,2016,36(3):569.[doi:10.13389/j.cnki.rao.2016.0151]
[5]冯希敏,祁颖,张凤妍,等.超声乳化人工晶状体植入联合房角分离术治疗急性原发性闭角型青光眼合并年龄相关性白内障患者的疗效分析[J].眼科新进展,2016,36(8):767.[doi:10.13389/j.cnki.rao.2016.0205]
　FENG Xi-Min,QI Ying,ZHANG Feng-Yan,et al.Phacoemulsification with goniosynechialysis for acute primary angle-closure glaucoma with age-related cataract[J].Recent Advances in Ophthalmology,2016,36(3):767.[doi:10.13389/j.cnki.rao.2016.0205]
[6]李维娜,李成茂,吴晓玉.晶状体超声乳化联合房角分离术治疗小梁切除术后复发的原发性闭角型青光眼合并白内障患者的临床疗效[J].眼科新进展,2021,41(7):676.[doi:10.13389/j.cnki.rao.2021.0140]
　LI Weina,LI Chengmao,WU Xiaoyu.Clinical efficacy of phacoemulsification with goniosynechialysis for recurrent primary angle-closure glaucoma with cataract after trabeculectomy[J].Recent Advances in Ophthalmology,2021,41(3):676.[doi:10.13389/j.cnki.rao.2021.0140]
[7]胡尊霞,司马晶,曹加国,等.晶状体超声乳化术联合房角镜直视下房角分离术治疗晚期原发性闭角型青光眼[J].眼科新进展,2021,41(9):870.[doi:10.13389/j.cnki.rao.2021.0182]
　HU Zunxia,SIMA Jing,CAO Jiaguo,et al.Phacoemulsification combined with goniosynechialysis under gonioscopy in the treatment of advanced primary angle-closure glaucoma[J].Recent Advances in Ophthalmology,2021,41(3):870.[doi:10.13389/j.cnki.rao.2021.0182]

备注/Memo

备注/Memo:
N/A
更新日期/Last Update: 2021-03-05