两种手术方式治疗原发性急性闭角型青光眼术后昼夜眼压比较

摘要

Objective To compare the 24-hour intraocular pressure fluctuation after two kinds of surgery, phacoemulsification combined with goniosynechialysis (PEGS) and phacoemulsification (PHACO), in patients of acute primary angle-closure glaucoma (APACG) with cataracts. Methods Sixty patients (60 eyes) diagnosed as APACG with cataracts in Qinhuangdao Haigang Hospital from June 2014 to November 2015 were randomly divided into two groups by random number table:30 patients with 30 eyes in the observation group (treated by PEGS) and 30 patients with 30 eyes in the control group (treated by PHACO). Changes in the 24-hour intraocular pressure (IOP) by noncontact tonome-ter (NCT) between the two groups 3 months after the operation were measured. Results The 24-hour IOP showed no statistically significant difference between the two groups before operation. After the operation, the average IOP, peak IOP, fluctuation value of IOP were (16.30 ± 1.19) mmHg, (18.90 ± 2.88) mmHg, (2.80 ± 2.58) mmHg in the observation group and (17.76±1.26) mmHg, (19.60±2.86) mmHg, (3.20±2.60) mmHg in the control group. The improvements in the observation group were significantly better than those in the control group (P<0.01). Conclusion The two kinds of sur-gery both can decrease the mean IOP and 24-hour IOP fluctuation effectively in APACG patients with cataracts, but PEGS was better than PHACO.%目的：观察合并白内障的原发性急性闭角型青光眼(APACG)行白内障超声乳化摘除加后房型人工晶体植入术（称为超声乳化术）及联合房角粘连分离术(超声乳化联合房角分离术)(PEGS)两种手术术后患者24 h眼压的改变情况。方法选取2014年6月至2015年11月于秦皇岛市海港医院眼科治疗的APACG患者60例(60眼)。依据随机数表法分为两组，观察组30例(30眼)行超声乳化后行房角分离术(PEGS)，对照组30例(30眼)行超声乳化术。非接触式眼压计(NCT)测量两组患者术后3个月昼夜眼压变化。结果两组患者术前昼夜眼压值比较差异均无统计学意义(P>0.05)；术后3个月，观察组患者平均眼压(16.30±1.19) mmHg、峰值眼压(18.90±2.88) mmHg、眼压波动值(2.80±2.58) mmHg；对照组平均眼压(17.76±1.26) mmHg、峰值眼压(19.60±2.86) mmHg、眼压波动值(3.20±2.60) mmHg。观察组较对照组改善更明显，差异均有显著统计学意义(P<0.01)。结论 PEGS与超声乳化术均能显著降低合并白内障的APACG患者的平均眼压，减少昼夜眼压波动，但PEGS效果优于超声乳化术。