摘要
目的研究超声乳化白内障吸除术(phacoemulsification,Phaco)联合房角黏连分离术(goniosynechialysis,GSL)治疗原发性急性闭角型青光眼(primary acute angle-closure glaucoma,APACG)合并白内障的疗效及对视盘血流密度的影响。方法选取四川省绵阳市第三人民医院2020年1月至2022年1月收治的APACG合并白内障患者96例,并根据随机数字表法分为对照组48例与观察组48例。对照组实施Phaco治疗,观察组实施Phaco-GSL治疗。比较两组手术效果[周边虹膜前黏连(peripheral synechia,PAS)、眼压、最佳矫正视力(intraocular pressure,best corrected visual acuity,BCVA)]、超声生物显微镜检查指标[前房深度(anterior chamber depth,ACD)、房角开放距离500(angle opening distance 500,AOD500)、小梁网睫状突距离(trabecular ciliary process distance,TCPD)]、视盘血流密度[整体视盘血流密度(whole en face image vessel density,wiVD)、视盘内血流密度(intraoptic disc vessel density,diVD)、视盘周围放射状毛细血管网(radial peripapillary capillary plexus,RPC)]及并发症发生情况。结果术后7d,两组PAS范围、IOP、BCVA均降低,观察组PAS范围、眼压、BCVA均低于对照组(P<0.05);两组ACD、AOD500、TCPD均增加,观察组ACD、AOD500、TCPD均高于对照组(P<0.05);两组wiVD、diVD及视盘周围RPC各项指标均增加,观察组wiVD、diVD及视盘围RPC各项指标均高于对照组(P<0.05);两组并发症总发生率比较,差异无显著性(P>0.05)。结论Phaco-GSL可进一步恢复APACG合并白内障患者的眼部结构,调节眼压与视力,同时改善视盘血流密度。
Objective To study the efficacy of phacoemulsification(Phaco)combined with goniosynechialysis(GSL)in the treatment of primary acute angle-closure glaucoma(APACG)complicated with cataract and its effect on optic disc vessel density.Methods The subjects were 96 patients with APACG complicated with cataract admitted to Mianyang Third People’s Hospital from January 2020 to January 2022.96 patients were randomly divided into two groups:control group(n=48)and observation group(n=48).Phaco was used to treat the control group,while PhACO-GSL was used to treat the observation group.The surgical effects[peripheral synechia(PAS),intraocular pressure,best corrected visual acuity(BCVA)],ultrasonic biomicroscopy detection indicators[anterior chamber depth(ACD),angle opening distance 500(AOD500),trabecular ciliary process distance(TCPD)],optic disc vessel density[whole en face image vessel density(wiVD),intraoptic disc vessel density(diVD),radial peripapillary capillary plexus(RPC)],and complications.Results On the 7th day after operation,the range of PAS,IOP and BCVA in the two groups were decreased(P<0.05),and the range of PAS,intraocular pressure and BCVA in the observation group were lower than those in the control group(P<0.05);The ACD,AOD500 and TCPD of the two groups were increased(P<0.05),and the ACD,AOD500 and TCPD of the observation group were higher than those of the control group(P<0.05);The indexes of wiVD,diVD and RPC around the optic disc increased in both groups(P<0.05),and the indexes of wiVD,diVD and RPC around the optic disc in the observation group were higher than those in the control group(P<0.05);there was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion Phaco-GSL can further restore the ocular structure of APACG patients with cataract,regulate intraocular pressure and visual acuity,and improve optic disc vessel density.
作者
张新
李奕萍
王晓华
杨瑞君
何吕福
ZHANG Xin;LI Yiping;WANG Xiaohua;YANG Ruijun;HE Lvfu(Department of Ophthalmology,Mianyang Third People’s Hospital·Sichuan mental health center,Mianyang Sichuan,621000)
出处
《中国临床医生杂志》
2023年第1期33-37,共5页
Chinese Journal For Clinicians
基金
四川省卫生和计划生育委员会科研项目(18PJ229)。
