摘要
目的比较原发性闭角型青光眼合并白内障患者选用白内障超声乳化术与小梁切除术的临床疗效。方法采用前瞻性随机对照设计，将78例（78只眼）原发性青光眼合并白内障患者按随机数字表法分两组，A组40例40只眼，行白内障超声乳化术，B组38例38只眼，行小梁切除术。观察两组患者术后1周、1月、3月时的眼压、视力、房角变化，并比较两组患者的术后并发症和住院时间。随访时间为3个月，采用x。检验和t检验分别对计数资料和计量资料进行统计学分析。结果手术后1周时平均眼压A组（11．2±2．3）mmHg，B组（12．1±3．9）mmHg，两组比较，差异无统计学意义（P〉0．05）；视力提高／〉0．3者A组34例，B组0例，两组比较，差异有统计学意义（P〈0．05）；视力提高〈O．2者A组4例，B组4例，另外34例视力均有下降；手术后1月时平均眼压A组（12．2±2．4）mmHg，B组（14．2±4．7）mmHg，两组比较，差异无统计学意义（P〉0．05）；视力提高≥0．3者A组37例，B组0例，两组比较，差异有统计学意义，（P〈0．05）；视力提高〈0．2者A组3例，B组7例，另外31例视力均有下降；手术后3月时平均眼压A组（13．2±3．3）mmHg，B组（16．1±4．9）mmHg，两组比较，差异有统计学意义（P〈0．05）；视力提高／〉0．3者A组30例，B组0例，两组比较，差异有统计学意义（P〈0．05）；视力提高〈0．2者A组8例，B组2例，另外36例视力均有下降；UBM测前房角人口A组增大，为（34．2±4．5）度，B组（12．2±6．1）度，两组比较，差异有统计学意义（P〈0．05）。结论原发性青光眼合并白内障患者选用自内障超声乳化术比小梁切除术从临床观察可以较好地控制眼压，并提高视力。
Objective To compare the efficacy of phacoemulsification versus trabeculectomy for the primary angle-closure glaucoma combined with cataract. Methods Seventy-eight patients （78 eyes） with primary angle-closure glaucoma and cataract were divided into two groups randomly. Group A accepted phacoemulsification （40 eyes）; group B trabeculectomy （38 eyes）. All patients were followed up 3 months postoperative. IOP changes, visual acuity/angle changes were observed, and the postoperative complications and hospital stay at lweek, 1 month and 3 months after the surgery were compared between the two groups. Data were analyzed using chi-square test and independent t-test. Results At 1 week after surgery, the mean lOP of group A was 11.2 ± 2.3mmHg, group B 12.1± 3.9 mmHg; the difference of the two groups was not statistically significant （P 〉0.05）. By international standards, the corrected visual acuity improved ≥ 0.3 were 34 cases in group A, 0 in group B, the difference of two groups was statistically significant （P 〈0.05）; the corrected visual acuity improved 〈0.2 was 4 cases in both group A and B, visual acuity of another 34 cases were decreased. At 1 month after surgery, the mean IOP of group A was 12.2 ±2.4mmHg, group B 14.2±4.7 mmHg, the difference of the two groups was not statistically significant （P 〉0.05）. By international standards, the corrected visual acuity improved ± 0.3 were 37 cases in group A, 0 in group B, the difference of two groups was statistically significant （P 〈0.05）; the corrected visual acuity improved 〈0.2 were 3 cases in group A, 7 in group B, visual acuity of another 31 cases were decreased. At 3 months after surgery, the mean IOP of group A was 13.2＋ 3.3mmHg, group B 16.1± 4.9 mmHg, the difference of the two groups was statistically significant （P 〈0.05）. By intemational standards, the corrected visual acuity improved ≥ 0.3 were 30 cases in group A, 0 in group B , the difference of two groups was statistically signifi- cant （P 〈0.05）, the corrected visual acuity improved 〈0.2 were 8 cases in group A, 2 in group B, visual acuity of another 36 cases were decreased. The anterior chamber angle entrance measured by UBM showed, group A was increased, as 34.2 ± 4.5 °, group B 12.2±6.1 °, the difference of two groups was statistically significant （P 〈0.05）. Conclusions For the primary glaucoma patients with cataract, phacoemulsification can better control intraocular pressure, improve visual activity and reduce postoperative complications than trabeculectomy.
出处
《中国实用眼科杂志》
CSCD
北大核心
2011年第12期1233-1236,共4页
Chinese Journal of Practical Ophthalmology
