目的：探讨晶状体及前部玻璃体切除术联合Ahmed阀植入术对晶状体半脱位继发青光眼眼压的影响。方法将86例(167眼)晶状体半脱位继发青光眼根据患者意愿分为2组,对照组49例(95眼)单纯采用Ahmed阀植入术治疗,观察组37例(72眼)采用晶状体及前部玻璃体切除术联合Ahmed阀植入术治疗。比较两组患者术前、术后第3d、术后第7d眼压变化；根据眼压等变化,评价两组手术效果,同时比较两组术后并发症发生率。结果治疗前,两组患者眼压比较,差异无统计学意义(P>0.05)；术后第3d,两组患者均显著降低,与治疗前比较,差异有统计学意义(P<0.05),但是组间比较,差异无统计学意义(P>0.05)；术后第7d,观察组眼压显著低于对照组,组间比较,差异有统计学意义(P<0.05)。观察组治疗有效率为88.9%,对照组为74.7%,观察组高于对照组,两组比较,差异有统计学意义(P<0.05)。观察组术后并发症发生率为9.5%,对照组为5.3%,两组比较,差异无统计学意义(P>0.05)。结论对于晶状体半脱位继发性青光眼患者,采用晶状体及前部玻璃体切除术联合Ahmed阀植入术能够有效降低眼压,具有疗效确切、安全性高等特点,值得临床上推广应用。%Objective To investigate the effect of Lens incision and anterior vitrectomy combined with Ahmed valve implantation on the traumatic secondary glaucoma associated with lens subluxation. Methods According to the wishes of patients, 86 cases (167 eyes) of raumatic secondary glaucoma associated with lens subluxation were divided into 2 groups. In the control group, 49 cases (95 eyes) were treated with Ahmed valve implantation, while in the observation group, 37 cases (72 eyes) were treated with Lens incision and anterior vitrectomy combined with Ahmed valve implantation. The intraocular pressure changes of two groups before operation, after operation on day 3 and on day 7were compared, and according to the changes of intraocular pressure and other changes, the surgical re-sults of the two groups were evaluated and the incidence rate of complications of the two groups after the operation were compared. Re-sults Before the treatment, there was no significant difference in IOP between the two groups (P>0. 05);After the operation on day 3, IOP in both groups were significantly reduced. Compared with before treatment, the difference was statistically significant ( P<0. 05), but there was no significant difference between the groups (P>0. 05);After the operation on day 7, the IOP in the observation group was significantly lower than that in the control group, the difference was statistically significant (P<0. 05). In addition, the ef-fective rate in observation group was 88. 9%, while in the control group was 74. 7%, the observation group was higher than the control group, the difference was statistically significant (P<0. 05). The complication rate after operation in the observation group was 9. 5%, while in the control group was 5. 3%, and the difference was not statistically significant (P>0. 05). Conclusion For the pa-tients with traumatic secondary glaucoma associated with lens subluxation, the lens incision and anterior vitrectomy combined with Ahmed valve implantation, which can effectively reduce the intraocular pressure, and it has the characteristics of definitely clinical effect and high safety, thus is worthy to be applied in the clinical.
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