CAJ | 학술논문

目的：评价并比较单切口和双切口超声乳化白内障摘除、人工晶状体植入联合小梁切除术治疗青光眼合并白内障的近期疗效。 　　方法：采用前瞻性随机对照临床试验研究，青光眼合并白内障的患者60例78眼。31例40眼行单切口超声乳化白内障摘除、人工晶状体植入联合小梁切除术，29例38眼行双切口手术。术后2wk；1mo观察视力、眼压、术后滤过泡、散光及术后并发症。 　　结果：术后全部患者都感到视力较术前提高，不同切口组间视力在术后2wk；1mo比较无显著差异（P＞0．05）；术后2wk；1mo两组患者的眼压较术前均降低，有显著性差异（P＜0．05），两组间比较无显著性差异（P＞0．05）；单切口组及双切口组功能滤过泡的眼数在术后2wk；1mo比较均无显著意义（P＞0．05）；术后2wk时，单切口组散光较术前增大，与同期的双切口组相比散光大，均有显著差异（P＜0．05）；术后1mo时，两组与术前相比、两组间比较均无显著差异（P＞0．05）；3眼术后出现少量前房积血，12眼术后早期出现角膜内皮水肿、后弹力层皱褶，6眼出现前房纤维素性渗出。 　　结论：双切口超声乳化白内障摘除、人工晶状体植入联合小梁切除术治疗青光眼白内障，手术操作简便、疗效佳，是一种理想的手术方式。
목적：평개병비교단절구화쌍절구초성유화백내장적제、인공정상체식입연합소량절제술치료청광안합병백내장적근기료효。 　　방법：채용전첨성수궤대조림상시험연구，청광안합병백내장적환자60례78안。31례40안행단절구초성유화백내장적제、인공정상체식입연합소량절제술，29례38안행쌍절구수술。술후2wk；1mo관찰시력、안압、술후려과포、산광급술후병발증。 　　결과：술후전부환자도감도시력교술전제고，불동절구조간시력재술후2wk；1mo비교무현저차이（P＞0．05）；술후2wk；1mo량조환자적안압교술전균강저，유현저성차이（P＜0．05），량조간비교무현저성차이（P＞0．05）；단절구조급쌍절구조공능려과포적안수재술후2wk；1mo비교균무현저의의（P＞0．05）；술후2wk시，단절구조산광교술전증대，여동기적쌍절구조상비산광대，균유현저차이（P＜0．05）；술후1mo시，량조여술전상비、량조간비교균무현저차이（P＞0．05）；3안술후출현소량전방적혈，12안술후조기출현각막내피수종、후탄력층추습，6안출현전방섬유소성삼출。 　　결론：쌍절구초성유화백내장적제、인공정상체식입연합소량절제술치료청광안백내장，수술조작간편、료효가，시일충이상적수술방식。
AIM: To compare the effects of one-site vs two-site phacotrabeculectomy, intraocular lens implantation with trabeculectomy in the treatment of glaucoma with cataract. METHODS: This prospective, randomized study including 60 patients ( 78 eyes ) with glaucoma and cataract. One -site approach was performed in 31 patients (40 eyes) and two-site approach in 29 patients (38 eyes).Visual acuity, intraocular pressure ( IOP), filtration, astigmatism and complications were observed at 2wk and 1mo after operation. RESULTS: Postoperative visual acuitywas improved in 78 eyes.There was no significant difference of visual acuity between two groups at 2wk and 1mo after operation ( P>0.05 ).The IOP at 2wk and 1mo after operation were lower than that of preoperation in two groups (P<0.05), and there was no significant difference between two groups (P>0.05).The number of eyes with functional filtration has no significant difference between two groups at 2wk and 1mo after operation ( P>0.05 );2wk after operation, the astigmatism in one -site approach was bigger than preoperative astigmatism, also bigger than that of two-site approach (P<0.05), and there was no significant difference of astigmatism between two groups at 1mo after operation (P>0.05). There were 3 cases with few hemorrhage in anterior chamber after operation, 12 cases with slight corneal epithelial edema, descemet membrane folds, 6 cases with cellulose exudation in anterior chamber. CONCLUSION: It is an ideal operation that two-site approachphacoemulsification and intraocular lens implantation combined with trabeculectomy in cataract and glaucoma patients, and has the advantages of simple operation, good treatment effect.