摘要
目的探讨超声乳化白内障吸出联合Ex-PRESS青光眼引流器植入术治疗合并白内障的原发性开角型青光眼的临床效果及安全性。方法采用前瞻性、随机、单盲、平行对照试验,选取合并白内障的原发性开角型青光眼患者,试验组入选20例(20眼),行超声乳化白内障吸出联合Ex-PRESS青光眼引流器植入术;对照组入选20例(20眼),行超声乳化白内障吸出联合小梁切除术,共观察12周。观察的指标包括眼压、视力、滤过泡、术后并发症等。结果术后12周,试验组眼压从(28.7±6.9)mmHg(1 kPa=7.5 mmHg)降至(11.3±2.5)mmHg,对照组从(29.1±7.1)mmHg降至(12.0±2.5)mmHg,两组病例术后眼压均明显降低(均为P<0.01),但在术后1 d、1周、4周时,试验组眼压较对照组更低(均为P<0.05)。至术后12周时,试验组手术完全成功率(95%)明显高于对照组(70%),差异有统计学意义(P<0.05)。试验组1眼出现引流器管口阻塞;对照组术后低眼压3眼、前房出血3眼、非功能性滤过泡2眼、恶性青光眼1眼。结论超声乳化白内障吸出联合Ex-PRESS青光眼引流器植入术治疗合并白内障的原发性开角型青光眼是安全且有效的。
Objective To investigate the clinical effects and safety of phacoemulsification cataract surgery combined with Ex-PRESS glaucoma filtration device implantation for primary open-angle glaucoma （POAG）with cataract. Methods This was a randominzed, moonblind, parallel group control study. And patients with POAG and cataract were chosen,20 patients of experimental group were treated by phacoemulsification cataract surgery combined with Ex-PRESS glaucoma filtration device implantation, while other 20 patients of the control group by phacoemulsification cataract surgery combined with trabeculectomy. Intraocular pressure （ IOP）, visual acuity, filtering bleb, postoperative complications were observed for 12 weeks. Results The postperative IOP in the experimental group decreased from （28.7 ± 5.9 ） mmHg （ 1 kPa = 7.5 mmHg） to （ 11.3 ±2. 5 ） mmHg, which in the control group was from （ 29. 1 ±7. 1 ） mmHg to （ 12.0 ±2.5） mmHg,the postoperative IOP within both groulas had significantly decreased （ all P 〈0.01 ） ,but the experimental group had a lower IOP level at postoperative 1 day,1 week and 4 weeks（ all P 〈0.05 ） ,and the surgical completely success rates in experimental group（95% ）was higher than that in the control group（70% ）at the end of fellow-up. One eye in experimental group had drainage tube occlusion,and in control group,low IOP were in 3 eyes,hyphema in 3 eyes, dysfunctional filtering bleb in 2 eyes and malignant glaucoma in l eye. Conclusion Phacoemulsification cataract surgery combined with Ex-PRESS glaucoma filtration device implantation is effective and safe for POAG with cataract.
出处
《眼科新进展》
CAS
北大核心
2014年第6期554-556,559,共4页
Recent Advances in Ophthalmology
