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

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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 words： Glaucoma Cataract Phacoemulsification Goniosynechialysis Trabeculectomy Efficacy

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