房角分离手术联合超声乳化人工晶状体植入术对白内障合并闭角型青光眼患者的临床疗效分析OACSTPCD
Analysis of clinical effect of angle separation surgery combined with surgery of phacoemulsification and intraocular lens implantation on visual recovery of patients with cataract combined with angle closure glaucoma
目的:探讨房角分离手术联合超声乳化人工晶状体植入术对白内障合并闭角型青光眼患者的临床疗效.方法:选取2022年1月至2023年1月间于北京康复医院就诊的198例白内障合并闭角型青光眼患者,根据治疗方法的不同将其分为对照组和观察组,每组99例.对照组行白内障超声乳化人工晶状体植入术联合小梁切除术;观察组行超声乳化人工晶状体植入术联合房角分离术.比较两组手术前后的临床相关指标与角膜内皮完整性、手术后3个月临床疗效,以及并发症发生情况.结果:观察组术后3个月临床疗效总有效率为95.96%,较对照组更佳,差异有统计学意义(x2=4.352,P＜0.05).两组治疗后3个月视力水平均有所提高,但组间比较差异无统计学意义(P＞0.05);前房深度和前房角度均有所增大,且观察组更大;眼压均有所降低,且观察组低于对照组,差异有统计学意义(t=7.654,P＜0.05).两组治疗后3个月角膜内皮细胞密度均有所减小,而观察组明显大于对照组;角膜内皮细胞平均面积与角膜中心厚度均有所增大,而观察组明显小于对照组,差异有统计学意义(t=25.233、16.608、6.698,P＜0.05).手术治疗后观察组并发症总检率为8.08%,低于对照组的19.19%,差异有统计学意义(x2=5.189,P＜0.05).结论:白内障合并闭角型青光眼患者实施房角分离手术联合超声乳化人工晶体植入术疗效确切,可有效提高患者视力水平,同时也改善了前房深度、前房角度和眼压,更利于维持患者角膜内皮细胞的完整性,且安全性较好.
Objective:To investigate the effect of angle separation surgery combined with surgery of phacoemulsification and intraocular lens implantation on visual recovery of patients with cataract combined with angle closure glaucoma.Methods:A total of 198 patients with cataract combined with angle closure glaucoma who admitted to Beijing Rehabilitation Hospital between January 2022 and January 2023 were selected,and they were divided into control group(99 cases)and observation group(99 cases)based on the difference of treatment methods.The control group underwent cataract phacoemulsification and intraocular lens implantation combined with trabeculectomy,while the observation group underwent phacoemulsification and intraocular lens implantation combined with surgery of angle separation.The clinical related indicators and corneal endothelial integrity,the clinical efficacy at the 3rd month after surgery and the occurrence of complications before and after surgery between two groups were compared.Results:The clinical efficacy at the 3rd month of observation group was better than that of control group(x2=4.352,P<0.05).The visual acuity levels of both two groups were improved after surgical treatment,but there was no statistically significant difference between the two groups(P>0.05).The depth and angle of the anterior chamber of two groups appeared increase,and those of observation group were significantly higher than them of control group.The intraocular pressures of two groups appeared decrease,and that of observation group was significantly lower than that of control group(t=7.654,P<0.05).The density of corneal endothelial cells in both groups decreased after surgical treatment,while the decrease degree of observation group was significantly higher than that of control group.Both the average area of corneal endothelial cells and the corneal central thickness increased,while the increase degree of observation group was significantly smaller than that of control group(t=25.233,16.608,6.698,P<0.05).After surgical treatment,the total detection rate of the complications in the observation group was 8.08%,which was significantly lower than 19.19%in the control group(x2=5.189,P<0.05).Conclusion:The curative effect of the combination of angle separation surgery and phacoemulsification and intraocular lens implantation is effective in patients with cataract combined with angle closure glaucoma.It can effectively improve their visual acuity levels,and improve depth,angle and intraocular pressure of anterior chamber,which is more conveniently to maintain the integrity of corneal endothelial cells of patients.It has favorable safety.
王鸿雁;张鲲;李倩;刘莹
首都医科大学附属北京康复医院眼科 北京 100144
临床医学
白内障闭角型青光眼房角分离术超声乳化人工晶状体植入术视力
CataractAngle closure glaucomaAngle separation surgeryPhacoemulsification and intraocular lens implantationVisual acuity
《中国医学装备》 2024 (005)
102-106 / 5
国家重点研发计划主动健康和老龄化科技应对重点专项课题(2020YFC2003100) National key research and development program active health and aging technology to key special topics(2020YFC2003100)
评论