白内障超声乳化吸除联合小梁切除术与白内障囊外摘除联合小梁切除术的疗效分析_论文.docxVIP

白内障超声乳化吸除联合小梁切除术与白内障囊外摘除联合小梁切除术的疗效分析 【摘要】 目的 观察白内障超声乳化吸除联合小梁切除术治疗青光眼合并白内障的临床疗效。方法 回顾分析患青光眼白内障在我院行超声乳化白内障吸除人工晶体植入联合小梁切除术的患者82例（82眼）和行白内障囊外摘除人工晶体植入联合小梁切除术的患者52例（54眼），记录手术前、后的视力和眼压，记录手术并发症和滤过泡情况。术后随访至少3个月。结果 两组术后1周和3个月矫正视力较术前明显提高，眼压较术前明显降低（P均＜）。两组间术后视力和眼压比较，差异无显著性（P＞）。术后3个月随访，眼压≥21mmHg者，超乳三联术组2眼，囊外三联术组4眼，两组比较差异无显著性（P＞）。手术并发症超乳三联术组明显低于囊外三联术组，差异有非常显著性（P＜）。两组术后均无严重并发症发生。结论 超声乳化白内障吸除人工晶体植入联合小梁切除术，可安全有效治疗青光眼合并白内障，且效果优于白内障囊外摘除人工晶体植入联合小梁切除术。 【关键词】 超声乳化白内障吸除术；白内障囊外摘除术；小梁切除术；青光眼；晶体 【Abstract】 Objective To evaluate the clinical effect of trabeculectomy combined with phacoemulsification for treatment of glaucoma with cataract.Methods This retrospective study included 134 cataract patients (136 eyes) with glaucoma. Among them， 82 patients (82 eyes) underwent the combined surgery of trabeculectomy and phacoemulsification with posterior chamber intraocular lens (IOL) implantation (phaco group)， 52 patients (54 eyes) underwent trabeculectomy combined with extracapsular cataract extraction (ECCE) and IOL implantation (ECCE group). Best-corrected visual acuity (BCVA) and intraocular pressure (IOP) of pre- and post-operation， postoperative bleb formation and postoperative complications were analyzed. All cases were followed up for over 3 months.Results In two groups， in 1 week and 3 months postoperation， the BCVA was obviously better and the mean IOP was distinctly lower than that of preoperation (P＜). There was no significant difference between the two groups in both BCVA and IOP postoperatively (P＞). In 3 months postoperatively， only two eyes’ IOP was ≥21mmHg in phaco group， and in ECCE group there were only four. The operative complications in phaco group were significantly less than that in ECCE group (P＜). No severe postoperative complications were revealed in all of operated eyes.Conclusion Trabeculectomy combined with phacoemulsification and posterior chamber intraocular lens implantation is a successful， safe and effective way of treatment for patients with glaucoma and cata