急性闭角型青光眼三种治疗方法的疗效比较
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Comparison of efficacy of procedures in the treatment of acute angle-closure glaucoma
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    摘要:

    目的:观察三种不同手术方式治疗急性闭角型青光眼的临床效果。

    方法:急性闭角型青光眼患者60例60眼,随机分为三组,A组行虹膜根部切除或激光虹膜切除术,B组行白内障超声乳化联合人工晶状体植入术加房角分离术,C组行小梁切除术。术前、术后1wk; 1,3,6mo随访观察视力、眼压、房角、前房深度变化,术后并发症及再手术情况。

    结果:术后视力:A,C组手术前后视力差异无统计学意义(P>0.05),B组手术前后差异具有统计学意义(P<0.01); 术后眼压:三组比较手术前后眼压降低均有显著性差异(P<0.05),其中C组降眼压效果最显著; 术后房角改变:术后B组使80%的房角全周开放,前房加深(P<0.01); 术后并发症:A组有10%~20%患者需要点药或再次手术治疗,B组术后并发症少,视力提高明显,C组术后并发症较多,部分严重且持久,需再次手术。

    结论:超声乳化白内障吸除联合房角分离术能够有效提高视力,降低眼压,开放房角,是一种治疗急性闭角型青光眼安全、有效的手术方法。

    Abstract:

    AIM: To observe the clinical effects of 3 different surgery treatments for acute angle-closure glaucoma.

    METHODS: Totally 60 cases of acute angle-closure glaucoma were randomly divided into 3 groups. Iris root excision or laser iridotomy was applied to group A, cataract phacoemulsification with artificial lens implantation and goniosynechialysis for group B, crabeculectomy for group C. The changes of vision, intraocular pressure, chamber angle, anterior chamber depth before and after operation were observed, while the postoperative complications and following operations were analyzed. The period of follow-up was one week, one month, three months and six months.

    RESULTS: No statistical significance was found for treatments of group A and C(P>0.05). For group C the treatment was statistically significant(P<0.01). Intraocular pressure: for all three groups intraocular pressure dropped with statistical significance(P<0.05)and group C was most effective. Chamber angle change: For group B 80% chamber angles were completely open and anterior chamber depth obviously increased(P<0.01); Postoperative complications: For group A 10% to 20% cases needed medical treatments or operations. Less complication were found for group B with better improvements of vision. For group C more complications were observed with some cases of severe and enduring cases which needed re-operation.

    CONCLUSION: Cataract phacoemulsification with artificial lens implantation and goniosynechialysis is a safe and effective surgery for treatment of acute angle-closure glaucoma, which can effectively improve vision, decrease intraocular pressure, open anterior chamber angle.

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苏连荣,李琦,魏海霞.急性闭角型青光眼三种治疗方法的疗效比较.国际眼科杂志, 2013,13(6):1181-1183.

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  • 收稿日期:2013-03-26
  • 最后修改日期:2013-05-28
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  • 在线发布日期: 2013-06-03
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