摘要
目的探究小切口超声乳化摘除术(Phaco)联合人工晶状体(IOL)植入及房角分离术治疗白内障并青光眼的疗效及对患者术后并发症的影响。方法于2018年1月—2019年1月方便选择94例(106眼)拟于该院行手术治疗的白内障并青光眼患者,按随机数字表法随机分为对照组(47例,52眼)与研究组(47例,54眼),对照组行小切口Phaco术联合IOL植入及小梁切除术,研究组行小切口Phaco术联合IOL植入及房角分离术,比较两组最佳矫正视力、平均眼内压、中央前房深度、视野及术后并发症情况。结果术后6个月内,对照组与研究组患者最佳在矫正视力(F=83.061、334.401,P<0.001)、平均眼内压(F=166.407、214.236,P<0.001)、中央前房深度(F=144.144、252.365,P<0.001)较术前均得到明显改善,且研究组术后1 d、1周、1个月、6个月的最佳矫正视力(t=9.336、11.809、15.285、13.551、11.063,P<0.001)、中央前房深度水平(t=2.162、6.074、4.490、9.799、8.501,P<0.001)均显著高于对照组,术后1 d、1周的平均眼内压显著低于对照组,差异有统计学意义(t=9.456、4.807,P<0.001);术后6个月,对照组与研究组平均视敏度值显著升高(t=4.289、11.064,P<0.001),视野平均缺损显著降低,差异有统计学意义(t=7.444、26.057,P<0.001),且研究组术后6个月的平均视敏度值显著高于对照组(t=2.015,P=0.046),视野平均缺损显著低于对照组,差异有统计学意义(t=10.410,P<0.001);术后6个月内,研究组并发症发生率为5.55%,显著低于对照组的19.23%,差异有统计学意义(χ^2=4.604,P=0.032)。结论小切口Phaco联合IOL植入及房角分离术是治疗白内障并青光眼安全有效的手术方案,能够降低眼压、提高术后视力,改善患者视功能,术后并发症风险较低。
Objective To investigate the efficacy of small incision phacoemulsification(Phaco)combined with intraocular lens(IOL)implantation and angle separation in the treatment of cataract and glaucoma and its effect on postoperative complications.Methods A total of 94 patients(106 eyes)with cataract and glaucoma who underwent surgery in the hospital form January 2018 to January 2019 were convenienty selected and randomly divided into the control group(47 patients,52 eyes)and the study group(47 patients,54 eyes).A small incision Phaco combined with IOL implantation and trabeculectomy was performed.The study group underwent small incision Phaco combined with IOL implantation and angle separation.The best corrected visual acuity,average intraocular pressure and central anterior chamber depth visual field and postoperative complications were compared between the two groups.Results Within 6 months after operation,the control group and the study group were best corrected for visual acuity(F=83.061,334.401,P<0.001),mean intraocular pressure(F=166.407,214.236,P<0.001),central anterior chamber depth,cant(F=144.144,252.365,P<0.001)was significantly improved compared with preoperative, and the best corrected visual acuity at 1d, 1 week, 1 month, and 6 months after surgery(t=9.336, 11.809, 15.285, 13.551, 11.063, P<0.001), the depth of the central anterior chamber was significantly higher than the control group(t= 2.162, 6.074, 4.490, 9.799, 8.501, P<0.001), the average intraocular pressure at 1 day, 1 week after surgery Significantly lower than the control group,the difference was statistically significant(t=9.456, 4.807, P<0.001);the mean visual acuity value of the control group and the study group increased significantly at 6 months after surgery(t=4.289, 11.064, P<0.001), visual field average The defect was significantly lower(t=7.444, 26.057, P<0.001), and the mean visual acuity value of the study group was significantly higher than that of the control group at 6 months after surgery(t=2.015, P=0.046). The average visual field defect was significantly lower than that of the control group. The control group,the difference was statistically significant(t=10.410, P<0.001);within 6 months after surgery, the complication rate of the study group was 5.55%, which was significantly lower than 19.23% of the control group,the difference was statistically significant(χ^2=4.604, P=0.032). Conclusion Small incision Phaco combined with IOL implantation and angle separation is a safe and effective surgical procedure for the treatment of cataract and glaucoma. It can reduce intraocular pressure, improve postoperative visual acuity, improve visual function of patients, and have lower risk of postoperative complications.
作者
黄丽娟
林雪松
HUANG Li-juan;LIN Xue-song(Department of Ophthalmology,Ningde Hospital,Fujian Medical University,Ningde,Fujian Province,325100 China)
出处
《中外医疗》
2019年第35期70-73,共4页
China & Foreign Medical Treatment
