青光眼白内障联合手术中用黏弹剂行房角分离的原理及优势
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Principle and advantages of using viscoelastic agent undergo goniosynechialysis during glaucoma and cataract combined surgery
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    摘要:

    目的:本文通过临床对照研究,比较黏弹剂和灌注液做房角分离的区别,从而探讨黏弹剂行房角分离的优势。

    方法:收集2012-09/2013-02入住首都医科大学附属北京同仁医院青光眼科,同时具有青光眼合并白内障的患者103例103眼,在1~2种抗青光眼作用下,眼压能够控制正常的初发或复发性闭角型青光眼合并有白内障的患者。将其随机分为试验组50例50眼和对照组53例53眼,两组患者均由相同手术者统一行白内障超声乳化摘除+人工晶状体植入+房角分离术。试验组术中用黏弹剂进行房角分离,对照组术中用灌注液进行房角分离,观察两组术后1mo眼压,前房轴深及房角宽度变化。

    结果:利用SPSS 19.0统计软件对数据进行分析,取单侧检验水平α=0.05,采用配对样本均数t检验和两独立样本均数的t检验,得出试验组眼压降低12.42±0.04mmHg,前房加深1.276±0.201mm,对照组眼压降低6.56±0.08mmHg,前房加深0.852±0.132mm,同时试验组房角开放程度亦明显优于对照组,两组比较有统计学意义(P<0.05)。

    结论:白内障超声乳化摘除+人工晶状体植入+房角分离术中用黏弹剂行房角分离,因其黏滞性高,能够有效的分离房角,从而更有效的控制眼压。

    Abstract:

    AIM: To investigate the advantage of using the medical sodium hyaluronate gel undergo goniosynechialysis, and to compare the difference of the viscoelastic agent and perfusion fluid by clinical control study.

    METHODS:Totally 103 cases(103 eyes)patients who had angle-closure glaucoma(ACG)with cataract all in Beijing Tongren Hospital affiliated to Capital Medical University, from September 2012 to February 2013. All the patients had primary glaucoma or recurrence ACG with cataract. Their intraocular pressure(IOP)could be controlled in normal value using one or two anti-glaucoma medications. We divided all the patients into two groups by chance. Experimental group had 53 cases(50 eyes), and control group had 50 cases(53 eyes). Two groups all had been performed phacoemulsification combined with goniosynechialysis by the same experiential operator. But experimental group did goniosynechialysis using the medical sodium hyaluronate gel, control group did goniosynechialysis using perfusion fluid. We observed the change of IOP, central anterior chamber depth and anterior chamber structure of two groups in postoperative 1mo.

    RESULTS: SPSS19.0 statistics software was utilized to analyze the data, This study selected one-side test α=0.05, adopted paired t-test or two-sample t-test. We obtained that experimental group IOP decreased 12.42±0.04mmHg, anterior chamber depth increased 1.276±0.201mm; that control group IOP decreased 6.56±0.08mmHg, anterior chamber depth increased 0.852±0.132mm. And experimental group anterior chamber angle opened more widely than the other group, the comparison had statistical significance(P<0.05).

    CONCLUSION:In phacoemulsification combine with goniosynechialysis,use medical sodium hyaluronate gel do goniosynechialysis can more effectively decrease IOP. This because the medical sodium hyaluronate gel has high glutinousness, it can separate angle of anterior chamber and controlling IOP effectively.

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张俊霞,王颖,陈琳,等.青光眼白内障联合手术中用黏弹剂行房角分离的原理及优势.国际眼科杂志, 2014,14(9):1677-1679.

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  • 收稿日期:2014-05-20
  • 最后修改日期:2014-07-30
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  • 在线发布日期: 2014-08-19
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