两种手术方式治疗急性闭角型青光眼合并白内障的对比研究

摘要

Objective To compare the clinical outcomes of two types of microsurgery in treatment of angle closure glaucoma with cataract.Methods This is a retrospective analysis of 36 patients (38 eyes) with acute angle closure glau-coma with cataract.Twenty patients (20 eyes) received cataract phacoemulsification and intraocular lens implantation com-bined with goniosynechialysis.The other 16 patients (18 eyes) underwent peripheral iridectomy.All patients were followed up for 6 months.Visual acuity,intraocular pressure ( IOP) , anterior chamber depth, anterior chamber angle and complica-tions were observed.Results Average postoperative IOP of all patients was <21 mmHg, significantly lower than that be-fore treatment ( P <0.05).Visual acuity, anterior chamber depth and angle adhesion range in patients who received goni-osynechialysis significantly improved after surgery ( P <0.05).In patients who underwent iridectomy, there were 10%who required assisted medication or secondary surgery.There were no serious complications in both groups.Conclusion Phacoemulsification combined with goniosynechialysis for proper patients with acute angle closure glaucoma with cataract was safe and effective.%目的：观察两种手术方式治疗急性闭角型青光眼合并白内障的初步临床疗效。方法回顾性分析合并有白内障的急性闭角型青光眼患者36例（38只眼），均为房角关闭粘连范围≤180°。其中A组行白内障超声乳化吸出人工晶状体植入联合房角分离手术20例（20只眼）；B组行周边虹膜切除术16例（18只眼）。随访6个月，对比分析术前和术后眼压、视力、前房深度、前房角的变化及并发症情况。结果两组手术前后眼压降低均有显著性差异（ P ＜0．05）；A组术后视力、前房深度、房角粘连范围均较术前明显改善，差异具有统计学意义（ P ＜O．05）；B组有10％患者需要辅助用药或再次手术治疗；两组术中术后均未发生严重并发症。结论超声乳化白内障吸除联合房角分离手术针对合适的急性闭角型青光眼合并白内障的患者是安全有效的。