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中国当代医药  2024, Vol. 31 Issue (11): 55-58    
  五官医学 本期目录 | 过刊浏览 | 高级检索 |
超声乳化联合房角分离或小梁切除对青光眼合并白内障患者的疗效比较
汪秀娟 邬义强 詹丽园
联勤保障部队第九〇七医院眼科,福建南平 353000
Comparison of therapeutic effect of phacoemulsification combined with goniosynechialysis or trabeculectomy in patients with glaucoma and cataract
WANG Xiujuan WU Yiqiang ZHAN Liyuan
Department of Ophthalmology,NO.907 Hospital of Joint Logistics Support Force,Fujian Province,Nanping 353000,China
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摘要 目的 探究超声乳化联合房角分离或小梁切除对青光眼合并白内障患者的疗效。方法 选取2018 年1 月至2022 年3 月联勤保障部队第九〇七医院眼科收治的100 例青光眼合并白内障患者作为研究对象,采用随机数字表法将其分为小梁切除组和房角分离组,每组各50 例。小梁切除组行超声乳化联合小梁切除术,房角分离组行超声乳化联合房角分离术,随访1 个月。比较两组患者的眼部指标、角膜内皮细胞指标及并发症发生情况。结果 术后1 个月,两组患者的视力、前房深度、散光度、前房角度高于术前,眼压低于术前,差异有统计数意义(P<0.05);术后1 个月,小梁切除组患者的视力、眼压、前房深度、前房角度低于房角分离组,散光度高于房角分离组,差异有统计数意义(P<0.05)。术后1 个月,两组患者的六角形细胞比率、细胞面积变异系数均高于术前,角膜内皮细胞密度低于术前,差异有统计数意义(P<0.05);术后1 个月,房角分离组患者的六角形细胞比率、细胞面积变异系数均高于小梁切除组,角膜内皮细胞密度低于小梁切除组,差异有统计数意义(P<0.05)。房角分离组的术后并发症发生率低于小梁切除组,差异有统计学意义(P<0.05)。结论 超声乳化联合房角分离或小梁切除对青光眼合并白内障患者视力改善效果相当,小梁切除术降眼压效果更为明显,而超声乳化联合房角镜下房角分离术对角膜内皮细胞造成的损伤较小梁切除更重,并发症较少,在临床实践中应结合患者具体情况为其选择适宜的术式。
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关键词 青光眼白内障超声乳化房角分离小梁切除术疗效    
Abstract:Objective To explore the efficacy of phacoemulsification combined with goniosynechialysis or trabeculectomy in patients with glaucoma and cataract.Methods A total of 100 patients with glaucoma combined with cataract admitted to Department of Ophthalmology,NO.907 Hospital of Joint Logistics Support Force from January 2018 to March 2022 were selected as the study objects.They were divided into trabeculectomy group and goniosynechialysis group by random number table method,with 50 cases in each group.The trabeculectomy group underwent phacoemulsification combined with trabeculectomy,and the goniosynechialysis group underwent phacoemulsification combined with goniosynechialysis,and the follow-up was 1 month.The ocular indexes,corneal endothelial cell indexes and complications were compared between the two groups.Results One month after surgery,the visual acuity,anterior chamber depth,astigmatism and anterior chamber angle of the two groups were higher than before surgery,and the intraoculer pressure was lower than before surgery,the differences were statistically significant (P<0.05).One month after surgery,the visual acuity,intraoculer pressure,anterior chamber depth and anterior chamber angle in trabeculectomy group were lower than those in goniosynechialysis group,and the differences were statistically significant(P<0.05).One month after surgery,the ratio of hexagonal cells and coefficient of variation of cell area were higher than before surgery,and the density of corneal endothelial cells was lower than before surgery,with statistical significance (P<0.05).One month after surgery,the ratio of hexagonal cells and the coefficient of variation of cell area in the goniosynechialysis group were higher than those in the trabeculectomy group,and the density of corneal endothelial cells was lower than that in the trabeculectomy group,with statistical significance (P<0.05).The incidence of postoperative complications in goniosynechialysis group was lower than that in trabeculectomy group,and the difference was statistically significant (P<0.05).Conclusion Phacoemulsification combined with goniosynechialysis or trabeculectomy has the same effect on visual acuity improvement in patients with glaucoma combined with cataract,and trabeculectomy has a more obvious effect on reducing intraocular pressure.Compared with trabeculectomy,phacoemulsification combined with goniosynechialysis causes more severe damage to corneal endothelial cells and fewer complications,so the appropriate operation should be selected according to the specific conditions of patients in clinical practice.
Key wordsGlaucoma    Cataract    Phacoemulsification    Goniosynechialysis    Trabeculectomy    Efficacy
    
引用本文:   
汪秀娟; 邬义强; 詹丽园. 超声乳化联合房角分离或小梁切除对青光眼合并白内障患者的疗效比较[J]. 中国当代医药, 2024, 31(11): 55-58.
WANG Xiujuan WU Yiqiang ZHAN Liyuan. Comparison of therapeutic effect of phacoemulsification combined with goniosynechialysis or trabeculectomy in patients with glaucoma and cataract. 中国当代医药, 2024, 31(11): 55-58.
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