[1]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):569-571.[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(6):569-571.[doi:10.13389/j.cnki.rao.2016.0151]
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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
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
36卷
期数:
2016年6期
页码:
569-571
栏目:
应用研究
出版日期:
2016-06-05

文章信息/Info

Title:
Phacoemulsification and intraocular lens implantation combined with goniosynechialysis for angle-closure glaucoma with age-related cataract
作者:
胡宏阁; 王钰清
461000　河南省许昌市，许昌市中心医院眼科
Author(s):
HU Hong-Ge; WANG Yu-Qing
Department of Ophthalmology,Xuchang Municipal Center Hospital, Xuchang 461 000, Henan Province, China
关键词:
房角分离术; 超声乳化术; 青光眼; 白内障
Keywords:
goniosynechialysis ;  phacoemulsification ;  glaucoma ;  cataract
DOI:
10.13389/j.cnki.rao.2016.0151
文献标志码:
A
摘要:
目的　对比观察超声乳化白内障吸出人工晶状体植入术联合及不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。方法　选取８９例（９８眼）闭角型青光眼合并年龄相关性白内障患眼分为两组，Ａ组４９眼采用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，Ｂ组４９眼行超声乳化白内障吸出人工晶状体植入术，对比观察两组患者手术前后的眼压、中央前房深度、房角结构等。结果　Ａ组术后１ａ眼压为（１４．３４±３．６４）ｍｍＨｇ（１ｋＰａ＝７．５ｍｍＨｇ），比术前眼压（３４．６５±６．５３）ｍｍＨｇ明显降低，差异有统计学意义（ｔ＝１９．２８，Ｐ＜０．０５）。Ｂ组术后１ａ眼压为（１６．２６±４．９１）ｍｍＨｇ，比术前（３５．１５±６．２７）ｍｍＨｇ亦明显降低，差异有统计学意义（ｔ＝１６．５５，Ｐ＜０．０５）。术后１ａ两组间眼压对比差异有统计学意义（ｔ＝２．１９，Ｐ＜０．０５）。Ａ组绝对成功３０眼（６１．２２％），相对成功９眼（１８．３７％），总成功率７９．５９％。Ｂ组绝对成功２７眼（５５．１０％），相对成功７眼（１４．２９％），总成功率６９．３９％。两组间的总成功率差异无统计学意义（Ｚ＝０．８８６，Ｐ＞０．０５）。Ａ组术后１个月中央前房深度（３．２４±０．３８）ｍｍ较术前（２．０４±０．３１）ｍｍ加深，差异有统计学意义（ｔ＝３．１４１，Ｐ＜０．０５）。Ｂ组术后１个月中央前房深度（３．０５±０．３６）ｍｍ较术前（２．０１±０．２９）ｍｍ亦加深，差异有统计学意义（ｔ＝３．０７８，Ｐ＜０．０５）。术后１个月两组比较差异无统计学意义（ｔ＝０．１７５，Ｐ＞０．０５）。术后１个月行房角检查：Ａ组４０眼前房角全部开放，９眼残留小于４５°的锥状或堤坝状粘连。Ｂ组１０眼３个象限残留房角粘连，１９眼２个象限残留房角粘连，２０眼有小于１个象限的房角粘连。两组视力改善率及术后并发症发生率差异均无统计学意义（均为Ｐ＞０．０５）。结论　超声乳化白内障吸出人工晶状体植入术联合房角分离术是治疗闭角型青光眼合并白内障的安全、有效的方法，对眼压、中央前房深度和房角结构都有明显改善。
Abstract:
Objective To investigate the clinical effects of phacoemulsification and intraocular lens ( IOL) implantation combined with goniosynechialysis or not for angle-closure glaucoma with cataract. Methods Ninty-eight eyes of 89 cases with primary angle-closure glaucoma and cataract were divided into two groups randomly. There were 49 eyes in group A and group B , respectively. Patients in group A were undergone phacoemulsification and IOL implantation. combined with goniosynechialysis. Patients in group B were treated with phacoemulsification and IOL implantation only. The changes of preoperative and postoperative anterior chamber angle ,intraocular pressure and central anterior chamber depth were observed and recorded. A1l cases were followed up for 12 months. Results In group A, the mean intraocular pressure before and I year after operation were ( 34. 65 + 6. 53) mmHg (1 kPa = 7. 5 mmHg) and ( 14. 34 + 3. 64 ) mmHg, respectively , there was statistically significant difference ( t = 19. 28 .P < 0. 05 ) . In group B , the mean intraocular pressure before and I year after operation were ( 35. 15 + 6. 27 ) mmHg and ( 16. 26 + 4. 91 ) mmHg , respectively , there was statistically sigruficant difference ( t = 16. 55 ,P < 0. 05 ) . One year after operation. the difference in the mean intraocular pressure between group A and group B was statistically significant ( t = 2. 19 .P < 0. 05 ) . The absolute successful rates in group A and B were 61. 22% ( 30/49) and 55. 10% (27/49) , the relative successful rates were 18. 37% ( 9/49) and 14. 2g% ( 7/49) . and the total successful rates were 79. 5g% and 69. 3g% , respectively. In group A, the mean central anterior chamber depth before and I month after operation were ( 2. 04 + 0. 31 ) mm and ( 3 . 24 + 0. 38 ) mm . respectively , there was statistically sigruficant difference( t = 3. 141 .P < 0. 05 ) . In group B, the mean central anterior chamber depth before and I month after operation were ( 2. 01 + 0. 29 ) mm and ( 3. 05 + 0. 36 ) mm , respectively , there was statistically significant difference ( t = 3. 078 .P < 0. 05 ) . One month after operation , the difference in the mean central anterior chamber depth between group A and group B was not statistically significant( t = 0. 175 .P > 0. 05 ) . In group A, the peripheral iris became flat after operation and anterior chamber angle widened in all eyes. Anterior chamber angle all opened in 40 eyes , goniosynechia in half quadrant remained in 9 eyes. In group B , goniosynechia remained in 3 quadrants in 10 eyes ,remained in two quadrants in 19 eyes , remained in one quadrant in 20 eyes. There was no statistical difference in visual acuity improvement rate and postoperative complications between two groups ( all P > 0. 05 ) . Conclusion Phacoemulsification and IOL implantation combined with goniosynechialysis is safe and effective in treatment of angle closure glaucoma with cataract. It can deepen the central anterior chamber. improve the figure of anterior chamber angle , and reduce the intraocular pressure.

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更新日期/Last Update: 2016-06-27