目的：探讨超声乳化吸除术联合房角分离术治疗原发性闭角型青光眼(primary angle-closure glaucoma，PACG)合并年龄相关性白内障的临床疗效。

方法：回顾性分析2014-02/2017-02于我院治疗原发性闭角型青光眼合并年龄相关性白内障患者66例70眼，按照治疗方式不同分为两组。将采用超声乳化白内障吸除人工晶状体植入术+房角分离术治疗的患者36例38眼设为观察组，未联合房角分离术的患者30例32眼设为对照组。比较两组患者手术总成功率，手术前后视力、眼压、前房深度，并记录并发症发生情况。

结果：观察组手术绝对成功率为63%，对照组为47%，观察组显著高于对照组，差异有统计学意义(P<0.05)，观察组总成功率为87%，对照组为84%，差异无统计学意义(P>0.05)。两组手术前后视力<0.1、0.1～<0.3、0.3～0.5、>0.5人数比较差异具有统计学意义(Z_观察组=7.545，P_观察组<0.05； Z_对照组=7.213，P_对照组<0.05)，术后两组间比较差异无统计学意义(Z=-1.456，P>0.05)。两组患者术后眼压较术前降低，差异有统计学意义(t_观察组=3.323，P_观察组=0.001； t_对照组=10.394，P_对照组<0.01)； 观察组眼压低于对照组，差异有统计学意义(t=14.802，P<0.01)。两组患者术后前房深度较术前增加，差异有统计学意义(t_观察组=0.411，P_观察组<0.01； t_对照组=15.621，P_对照组<0.01)； 观察组前房深度大于对照组，差异有统计学意义(t=15.246，P<0.01)。观察组术后并发症发生率为11%，对照组并发症发生率为25%，观察组显著低于对照组，差异有统计学意义(χ²=4.409，P=0.036)。

结论：超声乳化吸除术联合房角分离术治疗原发性闭角型青光眼合并年龄相关性白内障疗效确切，术后眼压控制效果更佳，且并发症发生率更低。

METHODS: Totally 66 cases(70 eyes)of patients with primary angle-closure glaucoma with age-related cataract treated in our hospital from February 2014 to February 2017 were selected as the objects of study. Retrospective analysis was implemented to their case data. There were 36 cases(38 eyes)of patients who were treated with phacoemulsification and intraocular lens implantation combined with goniosynechialysis were set as observation group, while the other 30 cases(32 eyes)of patients who were treated with phacoemulsification and intraocular lens implantation alone were set as control group. Two groups were compared for total success rate of surgery, the situation of eyesight, intraocular pressure, chamber depth and anterior chamber angle before and after surgery, moreover, the occurrences of complications were recorded.

RESULTS: The absolute success rate of surgery in observation group was 63%, while that of control group was 47%, and the observation group was dramatically higher than control group, with statistical significance(P<0.05). The total success rate of observation group was 87%, while that of control group was 84%, and the difference had no statistical significance(P>0.05). The difference in terms of the number of people whose eyesight were <0.1, 0.1-<0.3, 0.3-0.5 or >0.5 before surgery compared with after surgeries had statistical significance(Z_{observation group}=7.545, Z_{control group}=7.213; P<0.05), while the difference between groups after surgery had no statistical significance(Z=-1.456, P>0.05). After surgery, the intraocular pressure of both groups decreased significantly(t_{observation group}=3.323, P_{observation group}=0.001; t_{control group}=10.394, P_{control group}<0.01), and the observation group was significantly lower than control group after surgery, with a difference having statistical significance(t=14.802, P<0.01). Chamber depth of both groups decreased dramatically after surgery(t_{observation group}=0.411, P_{observation group}<0.01; t_{control grou}=15.621, P_{control grou}<0.01), and the difference between groups after surgery had statistical significance(t=15.246, P<0.01). The occurrence rate of complications in observation group was 11%, while that of control group was 25%, and observation group was significantly lower than control group, having statistical significance(χ²=4.409, P=0.036).

CONCLUSION: Goniosynechialysis combined with phacoemulsification have obvious efficacy in treating primary angle-closure glaucoma complicated with age-related cataract. It performs better in controlling intraocular pressure after surgery with lower occurrence rate of complication.