CAJ | 학술논문

目的：探讨超声乳化白内障吸除术联合人工晶状体植入术治疗闭角型青光眼的效果。方法选择2013年10月~2014年10月河北省保定市第二中心医院收治的60例(68眼)闭角型青光眼患者作为研究对象。按随机数字表法将患者分为对照组和观察组，每组各30例(34眼)。对照组施行小梁切除术，观察组施行超声乳化白内障吸除术联合人工晶状体植入术。两组术后均随访3个月，观察比较两组手术前后最佳矫正视力、眼压及前房深度，并记录两组并发症情况。结果两组术前视力比较，差异无统计学意义(P>0.05)。两组术后1周及随访3个月后最佳矫正视力均明显优于术前，差异有统计学意义(Z=6.218、8.322，均P<0.05)。观察组术后1周及随访3个月后最佳矫正视力均明显优于对照组术后1周及随访3个月后，差异有统计学意义(Z=7.925、9.437，均P<0.05)。两组术前眼压及前房深度比较，差异均无统计学意义(均P>0.05)。两组术后3个月眼压均较术前明显下降，差异有高度统计学意义(均P<0.01)，两组术后3个月前房深度均较术前明显扩大，差异有统计学意义(均P<0.05)，且观察组术后3个月前房深度较对照组扩大更明显，差异有统计学意义(P<0.05)。术后随访3个月，对照组患者出现2例脉络膜脱离、1例滤过泡漏，合计3例，占10.0%；观察组出现1例角膜水肿，占3.3%。两组并发症发生率比较，差异有统计学意义(χ2=4.127，P<0.05)。结论超声乳化白内障吸除术联合人工晶状体植入术治疗闭角型青光眼术后视力矫正效果显著，能明显降低眼压、扩大前房深度且术后并发症发生率低，值得临床上进一步推广应用。
목적：탐토초성유화백내장흡제술연합인공정상체식입술치료폐각형청광안적효과。방법선택2013년10월~2014년10월하북성보정시제이중심의원수치적60례(68안)폐각형청광안환자작위연구대상。안수궤수자표법장환자분위대조조화관찰조，매조각30례(34안)。대조조시행소량절제술，관찰조시행초성유화백내장흡제술연합인공정상체식입술。량조술후균수방3개월，관찰비교량조수술전후최가교정시력、안압급전방심도，병기록량조병발증정황。결과량조술전시력비교，차이무통계학의의(P>0.05)。량조술후1주급수방3개월후최가교정시력균명현우우술전，차이유통계학의의(Z=6.218、8.322，균P<0.05)。관찰조술후1주급수방3개월후최가교정시력균명현우우대조조술후1주급수방3개월후，차이유통계학의의(Z=7.925、9.437，균P<0.05)。량조술전안압급전방심도비교，차이균무통계학의의(균P>0.05)。량조술후3개월안압균교술전명현하강，차이유고도통계학의의(균P<0.01)，량조술후3개월전방심도균교술전명현확대，차이유통계학의의(균P<0.05)，차관찰조술후3개월전방심도교대조조확대경명현，차이유통계학의의(P<0.05)。술후수방3개월，대조조환자출현2례맥락막탈리、1례려과포루，합계3례，점10.0%；관찰조출현1례각막수종，점3.3%。량조병발증발생솔비교，차이유통계학의의(χ2=4.127，P<0.05)。결론초성유화백내장흡제술연합인공정상체식입술치료폐각형청광안술후시력교정효과현저，능명현강저안압、확대전방심도차술후병발증발생솔저，치득림상상진일보추엄응용。
Objective To investigate the effect of phacoemulsification combined with intraocular lens implantation in the treatment of angle-closure glaucoma. Methods 60 cases (68 eyes) of patients with angle-closure glaucoma admitted to the Second Central Hospital of Baoding City from October 2013 to October 2014 were selected as research objects. All patients were divided into control group and observation group by random number table with 30 cases (34 eyes) in each group. The patients of control group were taken trabeculectomy, while patients of observation group were taken phacoemulsification combined with intraocular lens implantation. The patients of the two groups were followed up for 3 months after operation. The best corrected visual acuity, intraocular pressure and chamber depth before and after operation between the two groups were observed and compared, and the conditions of complications of the two groups were recorded. Results There was no statistically significant difference of preoperative vision between the two groups (P > 0.05). The best corrected visual acuity after operation for 1 week and followed-up for 3 months of the two groups were all significantly better than preoperation (Z=6.218, 8.322, all P<0.05), and in the observation group, the best corrected visual acuity for 1 week after operation and 3 months followd-up were all better than those of control group (Z=7.925, 9.437, all P< 0.05). The intraocular pressures after operation for 3 months of control group and observation group [(15.37±4.84),(13.29±4.06)mmHg] were all decreased significantly compared with before operation [(32.28±12.02), (30.47±11.85)mmHg] (all P<0.01). The chamber depth after operation for 3 months of control group and observation group [(2.35±0.98), (3.16±1.08)mm] were all expanded significantly compared with preoperation [(1.68±0.45),(1.72±0.53)mm](all P< 0.05), and the chamber depth after operation for 3 months of observation group was expanded more significantly (P<0.05). 3 months followd-up after operation, 2 cases of choroidal detachment and 1 case of filtering bleb leak were found in the control group, 3 cases in total, accounting for 10.0%; 1 case of corneal edema was found in the observation group, accounting for 3.3%, and there were statistically significant differences about the incidence of complications between the two groups (χ2=4.127, P < 0.05). Conclusion Phacoemulsification combined with intraocular lens implantation in the treatment of angle-closure glaucoma has significant restoration effect on visual corrected after operation, which can significantly decrease intraocular pressure, expand chamber depth, and the incidence of postoperative complications is low, so it is worthy of clinical further promotion and application.