不同前房深度急性闭角型青光眼持续高眼压患者的手术方式及疗效分析

摘要

Objective To discuss the operative method and curative effect of persistent high intraocular pressure in acute angle-closure glaucoma patients with different anterior chamber depths. Methods 120 cases of patients with acute angle-closure glaucoma and lens opacification admitted and treated in our hospital from May 2012 to May 2014 were selected, 65 cases whose anterior chamber depth < 21 mm and re-open rate of anterior chamber angle < 180° were selected as the ob-servation group A, and they were given the ultrasonic emulsification and foldable intraocular lens implantation operation, 55 cases whose anterior chamber depth >21mm and re-open rate of anterior chamber angle >180° were selected as the obser-vation group B, and they were given the glaucoma combined with cataract two-incision, and both groups were given opera-tion at 3d after the stability of intraocular pressure. Results The postoperative follow-up discovered that the total-open ratio of anterior chamber angle in the observation group A was more than that in the observation group B,(P<0.05); the decrease range of postoperative intraocular pressure in the observation group A was higher than that in the observation group B,(P<0.05), but the increase range of postoperative vision in the observation group B was more than that in the observation group A (P<0.05),and the there was no difference in the incidence rate of complications between the observation group A and the observation group B (12.3% vs 10.9%),(P>0.05). Conclusion We can choose the specific operative method according to the actual condition and anterior chamber depth in clinical treatment of persistent high intraocular pressure in acute angle-clo-sure glaucoma.%目的：探讨不同前房深度急性闭角型青光眼持续高眼压患者的手术方式及临床疗效。方法方便选取2012年5月—2014年5月该院收治的急性闭角型青光眼合并晶状体浑浊患者120例，其中前房深度小于21 mm，前房角开放小于180°的65例患者为观察组A，采用超声乳化联合折叠人工晶状体植入手术，前房深度大于21 mm，前房角开放大于180°的55例患者为观察组B，采用青光眼、白内障双切口联合手术，两组均在眼压稳定3 d后进行手术。结果术后随访发现，观察组A前房角全部放开比率多于观察组B(P<0.05）；术后眼压降低幅度高于观察组B(P<0.05）；但观察组B术后视力提高幅度大于观察组A(P<0.05）。观察组A、B的并发症发生率分别为12.3%、10.9%，组间对比差异无统计学意义(P>0.05）。结论临床上在治疗急性闭角型青光眼持续高眼压时可根据患者的实际情况和前房深度选择具体的手术方式。