CAJ | 학술논문

目的：探讨不同手术方式对急性闭角型青光眼合并白内障患者的临床疗效。方法根据前房角粘连关闭程度将60例(60只眼)急性闭角型青光眼合并白内障患者分为三组：房角开放者采用超声乳化吸除术、人工晶状体植入术；房角粘连小于180°者采用超声乳化吸除术、人工晶状体植入术联合前房角分离术；房角粘连大于180°者采用超声乳化吸除术、人工晶状体植入术联合小梁切除术。治疗后随访6个月，观察所有患者视力，前房中央深度，眼压、房角检查结果及并发症。结果治疗后，所有患者房角粘连均重新开放，三种治疗方案均改善了患者的平均视力、前房中央深度及眼压，与治疗前比较差异均有统计学意义(P<0.05)；三组并发症的发生率比较差异均无统计学意义(P>0.05)。结论超声乳化吸除术、人工晶状体植入术和联合前房角分离术或合小梁切除术均可改善急性闭角型青光眼合并白内患者的视力状况、眼压水平及前房深度，疗效安全可靠。对于急性闭角型青光眼青光眼合并白内障患者的手术治疗应结合房角关闭程度选择合适的术式。
목적：탐토불동수술방식대급성폐각형청광안합병백내장환자적림상료효。방법근거전방각점련관폐정도장60례(60지안)급성폐각형청광안합병백내장환자분위삼조：방각개방자채용초성유화흡제술、인공정상체식입술；방각점련소우180°자채용초성유화흡제술、인공정상체식입술연합전방각분리술；방각점련대우180°자채용초성유화흡제술、인공정상체식입술연합소량절제술。치료후수방6개월，관찰소유환자시력，전방중앙심도，안압、방각검사결과급병발증。결과치료후，소유환자방각점련균중신개방，삼충치료방안균개선료환자적평균시력、전방중앙심도급안압，여치료전비교차이균유통계학의의(P<0.05)；삼조병발증적발생솔비교차이균무통계학의의(P>0.05)。결론초성유화흡제술、인공정상체식입술화연합전방각분리술혹합소량절제술균가개선급성폐각형청광안합병백내환자적시력상황、안압수평급전방심도，료효안전가고。대우급성폐각형청광안청광안합병백내장환자적수술치료응결합방각관폐정도선택합괄적술식。
Objective To explore the efficacy of different ways of surgery in patients with acute angle-clo-sure glaucoma combined with cataract. Methods According to the level of the anterior chamber angle closure, 60 cases (60 eyes) of patients with acute angle-closure glaucoma and cataract were divided into three groups: patients with opened angle (which were performed the phacoemulsification and intraocular lens implantation surgery), the pa-tients whose goniosynechia was less than 180°(which were performed the surgery of phacoemulsification and intraocu-lar lens implantation combined with goniosychialysis), and the patients whose goniosynechia was more than 180° (which were perfomed the phacoemulsification and intraocular lens implantation combined with trabeculectomy). The visual acuity, central anterior chamber depth, intraocular pressure and complications after the surgery in the three groups were observed. Results After treatment, all patients' goniosynechia were re-opened. The visual acuity, central anterior chamber depth and intraocular pressure were all better than those before the treatment (P<0.05). There was no statistically significant difference in the incidence of complications in the three groups after the treatment (P>0.05). Conclusion The surgery of phacoemulsification, intraocular lens implantation combined with goniosychialysis or tra-beculectomy can improve the visual acuity, central anterior chamber depth and intraocular pressure, which is safe and reliable. The degree of angle closure should be analyzed for the treatment of patients with acute angle-closure glauco-ma and cataract.