持续高眼压状态下手术治疗原发性闭角型青光眼的临床效果

摘要

目的 探讨在持续高眼压状态下手术治疗原发性闭角型青光眼的临床效果及对患者视力的影响.方法 选取2014年1月至2016年12月医院收治的持续高眼压状态下原发性闭角型青光眼患者90例(90眼),按照随机数字法分为对照组(n=45,45眼)和观察组(n=45,45眼).两组均行复合式小梁切除术治疗,对照组眼压均在正常范围内,眼压控制正常后3d手术治疗,观察组通过3~7 d局部、全身降压将眼压降低到最低后开始手术治疗,比较两组临床疗效.结果 两组治疗前视力情况比较差异无统计学意义(P>0.05);观察组术后1个月、3个月视力低于对照组(P<0.05);观察组术后6个月、1年视力与对照组比较差异无统计学意义(P>0.05);观察组术前及术后1个月眼压水平高于对照组(P<0.05);两组术后3个月、6个月及1年眼压水平比较差异无统计学意义(P>0.05);观察组术后并发症发生率为8.89%,对照组为6.67%,两组术后并发症发生率比较差异无统计学意义(P>0.05).结论 持续高眼压状态下原发性闭角型青光眼患者采用复合式小梁切除术治疗效果理想,但是术前高眼压持续时间越长,手术预后越差,术前应采取措施降眼压,改善手术预后.%Objective To investigate the clinical effect of surgical treatment on primary angle closure glau-coma in patients with persistent high intraocular pressure(IOP).Methods A total of 90 cases(90 eyes)with primary angle closure glaucoma combined with IOP were selected from January 2014 to December 2016 admit-ted to the hospital were selected as subjects,and they were randomly divided into control group(n= 45,45 eyes)and observation group(n=45,45 eyes).The two groups underwent compound trabeculectomy.For the treatment of the control group,w hen the intraocular pressure in the normal range,the surgery had been con-ducted after three days.For the observation group,when the local and systemic blood pressures were con-trolled to the lowest level through 3-7 d,surgery had started,and clinical curative effects were compared be-tween the two groups.Results Difference in visual acuity before treatment between the two groups had no statistically significance(P>0.05).Visual acuity of one month and three months of the patients in the obser-vation group were significantly lower than that of the control group(P<0.05).The visual acuity of observa-tion group after six months and one year had no significant difference with the control group(P>0.05).The intraocular pressures between the two groups had no statistical significance after three months,six months and one years after the surgery(P>0.05).The levels of intraocular pressure of one month before and after the op-eration of observation group were significantly higher than that of the control group(P<0.05).The incidence of complications was 8.89% patients in the observation group,which of the control group was 6.67%,the difference was no statistical significance(P>0.05).Conclusion Continuous high intraocular pressure of pri-mary angle closure glaucoma with compound trabeculectomy treatment effect is ideal,but the longer the preop-erative IOP of duration of surgery,the worse of the prognosis.And preoperative measures should be taken to reduce intraocular pressure and to improve prognosis.