超声乳化IOL植入术联合小梁切除术治疗白内障合并青光眼的疗效

Curative effect of phacoemulsification and IOL implantation combined with trabeculectomy in the treatment of cataract with glaucoma

摘要:

目的：观察超声乳化人工晶状体(IOL)植入术联合小梁切除术对白内障合并青光眼患者中央前房深度(ACD)、散光的影响。

方法：选取2018-11/2019-11我院收治的白内障合并青光眼患者100例100眼为研究对象进行前瞻性研究，按照随机数字法分为对照组50例50眼给予超声乳化IOL植入术治疗和观察组50例50眼给予超声乳化IOL植入术联合小梁切除术治疗，比较两组患者术后1、2wk，1mo的BCVA(LogMAR)、眼压(IOP)、ACD、散光、视觉质量及并发症发生率。

结果：术后1、2wk， 1mo，两组ACD较术前升高，BCVA(LogMAR)、IOP均较术前降低(P<0.05)，且观察组ACD高于对照组，BCVA(LogMAR)、IOP低于对照组(P<0.05)； 术后1、2wk两组散光较术前升高，术后1mo观察组散光降低(P<0.05)，且观察组散光低于对照组(P<0.05)。术后1mo，观察组看电视、阅读书写及精细操作评分均高于对照组(P<0.05)。观察组并发症发生率低于对照组(6% vs 22%，P<0.05)。

结论：超声乳化IOL植入术联合小梁切除术治疗白内障合并青光眼患者疗效显著，可提高视力和视觉质量，降低眼压和散光，加深ACD，减少并发症发生率。

Abstract:

AIM:To observe the effect of phacoemulsification and intraocular lens(IOL)implantation combined with trabeculectomy on the central anterior chamber depth(ACD)and astigmatism of patients with cataract and glaucoma.

METHODS:This prospective study included 100 patients(100 eyes)with cataract and glaucoma who were admitted to the hospital between November 2018 and November 2019. The patients were divided into control group(n=50, 50 eyes)and observation group(n=50, 50 eyes)by the random number table method. The control group was treated with phacoemulsification and IOL implantation, while the observation group was treated with phacoemulsification and IOL implantation combined with trabeculectomy. The LogMAR visual acuity, intraocular pressure(IOP), ACD and astigmatism at 1wk, 2wk and 1mo after operation, visual quality, and the incidence of complications were compared between the two groups.

RESULTS:Compared with preoperative, the ACD of the two groups increased, LogMAR visual acuity and IOP decreased at 1wk, 2wk and 1mo after operation(P<0.05). Moreover, the ACD of the observation group at 1wk, 2wk and 1mo after operation were higher than those of the control group, and the LogMAR visual acuity, IOP was lower than that of the control group(P<0.05). The astigmatism of the two groups increased at 1,2wk after operation, and obseration group decreased at 1mo after operation(P<0.05). Meanwhile, the astigmatism of the observation group was lower than that of the control group(P<0.05). At 1mo after operation, the scores of watching TV, reading and writing, and fine operation of the observation group were higher than those of the control group(P<0.05). The incidence of complications in the observation group was lower than that in the control group(6% vs 22%, P<0.05).

CONCLUSION:Phacoemulsification and IOL implantation combined with trabeculectomy is markedly effective in the treatment of patients with cataract and glaucoma, which can improve vision and visual quality. Lower intraocular pressure and astigmatism, reduce changes in astigmatism, deepen the central anterior chamber depth, and reduce the incidence of complications.