摘要
目的:观察激光周边虹膜成形术(ALPI)联合白内障超声乳化(Phaco)及房角黏连分离术(GSL)治疗急性闭角型青光眼(AACG)合并白内障的临床疗效。方法:选取2022年6月-2024年1月于我院眼科就诊的AACG合并白内障患者90眼作为研究对象行前瞻性研究,采用随机数表法分为观察组及对照组各45眼,对照组行Phaco联合GSL治疗,观察组行ALPI联合Phaco及GSL术;并于术前及术后1周、1月、3月、6月进行随访,收集2组术前及术后最佳矫正视力(BCVA)、眼压(IOP)、前房深度(ACD)、虹膜小梁夹角(TIA)、房角分级及术后前房出血、角膜水肿、前房炎性反应等并发症发生率,统计差异。结果:术后两组患者ACD均较术前加深,TIA增宽,BCVA提升,房角分级下降(P<0.05);且观察组术后各时间较对照组TIA更大、眼压更低,差异有统计学意义(P<0.05),两组术后各时间点ACD、房角分级、BCVA均无统计学差异(均P>0.05),且术后均未发生恶性青光眼、后囊破裂等严重并发症,并发症不良率与手术疗效差异均无统计学意义(P>0.05)。结论:ALPI联合白内障超声乳化及房角黏连分离术治疗AACG合并白内障患者,能有效增大TIA,缓解虹膜前粘连,进而降低患者眼压、具有稳定的临床疗效。
Objective To observe the clinical efficacy of argon laser peripheral iridoplasty(ALPI)combined with phacoe⁃mulsification cataract surgery(Phaco)and goniosynechialysis(GSL)in the treatment of acute angle-closure glaucoma(AACG)with concurrent cataract.Methods A prospective study was conducted on 90 eyes with AACG and cataract who visited our ophthalmology department from June 2022 to January 2024.Using a random number table method,the patients were divided into an observation group and a control group,with 45 eyes each.The control group underwent Phaco com⁃bined with GSL,while the observation group received ALPI combined with Phaco and GSL.Follow-ups were conducted one week,one month,three months,and six months post-operation to collect data on preoperative and postoperative best-cor⁃rected visual acuity(BCVA),intraocular pressure(IOP),anterior chamber depth(ACD),trabecular-iris angle(TIA),angle grading,and the incidence of complications such as anterior chamber hemorrhage,corneal edema,and inflammatory reactions.Statistical differences were analyzed.Results Postoperatively,both groups showed a deeper ACD and a wider TIA,improved BCVA,and a decrease in angle grading(P<0.05).Moreover,the observation group had a greater TIA and lower IOP at all postoperative time points compared to the control group,with statistically significant differences(P<0.05).There was no statistical significance in ACD,angle grading,and BCVA at any postoperative time point between the two groups(all P>0.05).No severe complications like malignant glaucoma or posterior capsule rupture occurred postoperatively in either group.The incidence of complications and the difference in surgical outcomes were not statistically significant(P>0.05).Conclusion ALPI combined with phacoemulsification cataract surgery and goniosynechialysis is effective in treating patients with AACG and concurrent cataract by enlarging the TIA,relieving iris bombe,and thus reducing IOP,offering stable clinical efficacy.
作者
樊永骐
余锦强
李德坤
FAN Yong-qi;YU Jin-qiang;LI De-kun(Ophthalmology Cen-ter,Renmin Hospital,Hubei University of Medicine,Shiyan,Hubei 442000,China)
出处
《湖北医药学院学报》
CAS
2024年第3期271-274,281,共5页
Journal of Hubei University of Medicine
关键词
急性闭角型青光眼
激光周边虹膜成形术
白内障超声乳化
房角分离
Acute angle-closure glaucoma
Laser peripheral iridoplasty
Phacoemulsification for cataract removal
Angle separation
