目的：探讨超声乳化联合房角分离术治疗白内障伴闭角型青光眼的临床疗效。

方法：回顾性分析 2013-05/2014-12我院收治的113例120眼闭角型青光眼伴白内障患者的临床资料，其中88眼行晶状体超声乳化联合前房角分离术治疗(A组)，另32眼行单纯白内障超声乳化术治疗(B组)。于术后1wk，1、2、6mo，1a进行随访，记录并比较随访各期间两组患者治疗前后的视力、视野、眼压、前房深度、前房角分级和并发症。

结果：视力：术后1wk，1、2、6mo，1a，两组患者平均视力均较术前提高，差异有统计学意义(P<0.05)，且A组较B组效果更好。视野：术后1wk，1、2、6mo，1a，两组患者视野均较术前增加，差异有统计学意义(P<0.001)，且A组增加幅度显著高于B组。眼压：术后1wk，1、2、6mo，1a，两组患者平均眼压均较术前降低，差异有统计学意义(P<0.001)，但A组下降幅度显著高于B组。前房深度：术后1wk，1、2、6mo，1a，两组患者前房深度平均值均较术前升高，差异有统计学意义(P<0.001)，且A组较B组升高幅度显著高于B组。前房角分级：术后1wk，1、2、6mo，1a，两组患者分级均较术前改善，差异有统计学意义(P<0.001)，且A组改善效果明显优于B组。两组患者术后均无严重并发症发生。

结论：与单纯采用白内障超声乳化术治疗白内障伴闭角型青光眼相比，超声乳化联合房角分离术更加安全有效，且在增加前房深度和视野、改善前房角开放程度、提高视力和降低眼压等方面，效果更好。

METHODS: From May 2013 to December 2014, 120 eyes of 113 patients with cataract and glaucoma admitted to our department were selected, and their clinical data were retrospectively analyzed. Among them, 88 eyes received phacoemulsification combined with goniosynechialysis(Group A), 32 eyes received phacoemulsification(Group B). All the patients were followed up at 1wk, 1, 2, and 6mo and 1a postoperatively. The visual acuity, intraocular pressure, visual field, anterior chamber depth and angle changes before and after the surgery were compared between the two groups.

RESULTS: Vision: at each follow-up time point, their vision was improved significantly than before the surgery(P<0.05)in both the groups, and Group A was significantly better than that in Group B(P<0.05). Intraocular pressure: compared with preoperative data, it decreased significantly at each follow-up time point(P<0.05), and Group A significantly decreased much more compared with Group B(P<0.05). Visual field: compared with preoperative data, it increased significantly at each follow-up time point(P<0.05), and Group A significantly had better effect than Group B(P<0.05). After the surgery, the anterior chamber depth were evidently higher than those before the surgery(P<0.001), and Group A significantly had higher anterior chamber depth than Group B(P<0.05). The angle grading after the surgery were improved remarkably than before the operation(P<0.05), and Group A was significantly superior to Group B. There were no serious complications in the two groups.

CONCLUSION: Compared with simply phacoemulsification, phacoemulsification combined with goniosynechialysis is safer, and has better effectiveness for cataract patients with glaucoma. In addition, the latter has advantages in increasing the depth of the anterior chamber, and improving the openness of angle, as well as improving the vision and visual field, while reducing the intraocular pressure.