白内障超声乳化联合房角分离术治疗周边虹膜切除术后合并白内障

Clinical study on the treatment of cataract after peripheral iridectomy by phacoemulsification combined with goniosynechialysis

摘要:

目的：探讨白内障超声乳化联合房角分离术与单纯白内障超声乳化治疗周边虹膜切除术后合并白内障的临床疗效。

方法：周边虹膜切除术后合并白内障患者69例85眼，随机分抽签法分为两组，观察组38例45眼，行白内障超声乳化联合人工晶状体植入联合房角分离术，对照组31例40眼行白内障超声乳化联合人工晶状体植入术，术后随访12mo，比较两组手术前后眼压、视力、中央前房深度及房角的变化。

结果：术后1wk，观察组与对照组平均眼压分别为10.36±2.85、12.09±3.75mmHg，均较术前降低，与术前比较差异有统计学意义(P<0.01)，组间比较差异有统计学意义(t=2.41，P<0.05)。观察组与对照组平均视力分别为0.52±0.22、0.55±0.20，较术前均明显提高，与术前比较差异有统计学意义(P<0.01)，组间比较差异无统计学意义(t=0.65，P>0.05)。观察组与对照组中央前房平均深度分别为3.57±0.32、3.44±0.35mm，均较术前明显增加，与术前相比较差异有统计学意义(P<0.01)，组间比较差异无统计学意义(t=1.79，P>0.05)。术后2mo，观察组房角粘连范围<90°共42眼(93.33%)，高于对照组的31眼(77.50%)，两者相比较差异有统计学意义(P<0.05)。

结论：白内障超声乳化联合房角分离术治疗周边虹膜切除术后合并白内障，可以有效开放粘连的房角，控制眼压并提高视力，是一种安全有效的治疗方法。

Abstract:

AIM:To investigate the clinical efficacy of phacoemulsification combined with goniosynechialysis and only phacoemulsification on coexisted cataract after peripheral iridectomy.

METHODS:A total of 69 patients(85 eyes)with coexisted cataract after peripheral iridectomy were divided into two groups by drawing lots method. The patients in observation group(38 cases,45 eyes)were treated with phacoemulsification and IOL implantation, combined with goniosynechialysis, and the control group(31 cases,40 eyes)with phacoemulsification and IOL implantation. The follow-up time lasted 12mo. The intraocular pressure(IOP), best corrected visual acuity(BCVA), central anterior chamber depth and the change of anterior chamber angle of two groups before and after operations were compared and analyzed.

RESULTS:After 1wk, the postoperative mean IOP of observation group was 10.36±2.85mmHg,that of control group was 12.09±3.75mmHg, decreased significantly compared with preoperative(P<0.01). There was significant difference of that between two groups(t=2.41,P<0.05). The postoperative mean visual acuity of observation group and control group were 0.52±0.22 and 0.55±0.20 respectively,increased significantly compared with preoperative(P<0.01),and no significant difference between two groups(t=0.65,P>0.05). The postoperative mean central chamber thickness of observation group and control group were 3.57±0.32mm and 3.44±0.35mm respectively,increased significantly compared with preoperative(P<0.01), and no significant difference between two groups(t=1.79,P>0.05). Two months after the operation, there were 42eyes(93.33%)with adhesion range of anterior chamber angle was <90°in observation group, more than that in control group 31eyes(77.50%), the difference was significant(P<0.05).

CONCLUTION:The treatment method of phacoemulsification combined with goniosynechialysis for coexisted cataract after peripheral iridectomy can effectively open the adhesions of chamber angular, control the IOP and improve visul acuity and is safe.