临床眼科杂志2025，Vol.33Issue(3)：209-215,7.DOI:10.3969/j.issn.1006-8422.2025.03.004
飞秒激光辅助白内障超声乳化联合不同房角分离术在急性闭角型青光眼治疗中的疗效分析
The clinical efficacy of femtosecond laser-assisted cataract phacoemulsification combined with different methods of angle separation surgery in treating acute attacks of primary acute angle-closure glaucoma compli-cated with cataracts
摘要
Abstract
Objective To analyze the clinical efficacy of femtosecond laser-assisted cataract phacoemulsification combined with different methods of angle separation surgery in treating acute attacks of acute primary angle-closure glau-coma complicated with cataracts.Methods The prospective case-control study.48 eyes of 44 patients with acute attacks of primary acute angle-closure glaucoma complicated with cataracts admitted to our hospital from January 2023 to June 2024 were selected.Patients were grouped based on the surgical method:the study group included 22 patients(26 eyes)who un-derwent femtosecond laser-assisted cataract phacoemulsification combined with intraoperative gonioscopy-guided angle separation surgery,referred to as the"Direct Group".The control group included 22 patients(22 eyes)who underwent femtosecond laser-assisted cataract phacoemulsification combined with angle separation surgery without intraoperative goni-oscopy assistance,referred to as the"Blind Group".The best corrected visual acuity,intraocular pressure,angle opening range and angle,anterior chamber volume,and central anterior chamber depth were analyzed before and after the surgery,along with intraoperative and postoperative complications.Results Intraocular pressure comparisons within each group be-fore and after the surgery showed changes at each time point for both groups.Inter group comparisons indicated no differ-ences preoperative,but postoperative intraocular pressure in the A group was lower than in the B group(P<0.05).The postoperative intraocular pressure was significantly lower as compared to the preoperative intraocular pressure in the A group.Best corrected visual acuity comparisons within each group before and after the surgery showed improvement at each time point postoperatively for both groups.Inter group comparisons revealed no differences preoperative and at 1 day,1 week,and 1 month postoperatively,but at 3 months postoperatively,visual acuity in the A group was superior to that in the B group(P<0.05).The postoperative visual acuity was superior to that preoperative in the A group.Comparisons of angle width and anterior chamber volume before and after the surgery showed no differences for either surgical method.However,within-group comparisons indicated a significant increase in angle width and volume postoperatively.The postop-erative angle width and anterior chamber volume were significantly increased as compared to the preoperative in the A group.Both surgical methods were effective in terms of angle opening range,with the A group showing superior results com-pared to B group.Regarding complications,the Direct group was more prone to anterior chamber angle bleeding,while there were no statistical differences in postoperative pupil dilation and iris damage between the two groups.There were no statistical differences in the continuity and centration of the femtosecond laser capsulotomy between the two groups,and no serious complications occurred during or after the surgery,with high postoperative satisfaction.Conclusions Femtosec-ond laser-assisted cataract phacoemulsification combined with angle separation surgery is effective in treating acute angle-closure glaucoma complicated with cataracts.It also reduces the risk of shallow anterior chamber circular capsulotomy and surgical risks,enhancing surgical safety and success rates.The direct visualization of the angle during surgery ensures a wider and more effective angle separation,achieving an angle opening range of over 180 degrees,which is beneficial for re-storing physiological aqueous humor drainage function.关键词
飞秒激光辅助白内障/急性闭角型青光眼/前房容积/前房深度、术中房角镜、房角分离术Key words
Femtosecond laser-assisted cataract surgery/Acute angle-closure glaucoma/Anterior chamber vol-ume/Anterior chamber depth/Intraoperative gonioscopy/Goniosynechialysis引用本文复制引用
李凯,陈亚茹,周围,刘秀云..飞秒激光辅助白内障超声乳化联合不同房角分离术在急性闭角型青光眼治疗中的疗效分析[J].临床眼科杂志,2025,33(3):209-215,7.基金项目
安徽医科大学校基金资助项目(2021xkj253) （2021xkj253）
