| 摘要: |
| 目的：探讨超声乳化白内障吸除+人工晶状体（IOL）植入术联合房角分离术或小梁切除术治疗原发性急性闭角型青光眼（APACG）合并白内障患者对视神经结构的影响。方法：本文为前瞻性单盲对照研究。选取2021年6月~2025年1月于铜仁市人民医院诊治的128例APACG合并白内障患者作为研究对象。按照随机数字表法分为观察组（予以超声乳化白内障吸除+IOL植入术联合房角分离术）和对照组（予以超声乳化白内障吸除+IOL植入术联合小梁切除术），每组64例。比较临床疗效、视神经纤维厚度、前房深度、前房角度、眼压、BCVA及并发症。结果：2组前房深度、眼压、前房角度、BCVA的时间效应、时间和组间交互作用、组间效应显著（P<0.05）；2组视神经纤维厚度的时间效应、组间效应显著（P<0.05），时间和组间交互作用无差异（P＞0.05）。观察组T1~T2时点的前房深度、角度和T1时点的视神经纤维厚度均高于对照组，T1时点的眼压低于对照组（P＜0.05）；观察组术后1、3、6个月的BCVA均高于对照组（P＜0.05）。2组T2时点的眼压、视神经纤维厚度比较无差异（P＞0.05）。结论：超声乳化白内障吸除+IOL植入术联合房角分离术治疗，可有效控制眼压和改善视力，并对视网膜损伤轻，并发症风险低。 |
| 关键词: 超声乳化白内障吸除 人工晶状体植入术 房角分离术 急性闭角型青光眼 白内障患者 |
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| The influence of anterior chamber Angle separation and trabeculectomy on the changes of optic nerve structure in patients with acute angle-closure glaucoma during phacoemulsification cataract extraction +IOL implantation |
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XUli1,2,3
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1.Tongren People'2.'3.s Hospital
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| Abstract: |
| Objective: To explore the effect of phacoemulsification cataract aspiration + intraocular lens (IOL) implantation combined with anterior chamber Angle separation or trabeculectomy on the optic nerve structure in patients with primary acute angle-closure glaucoma (APACG) complicated with cataract. Method：This article is a prospective single-blind controlled study. A total of 128 patients with APACG combined with cataract who were diagnosed and treated in Tongren People's Hospital from June 2021 to January 2025 were selected as the research subjects. According to the random number table method, they were divided into the observation group (treated with phacoemulsification cataract aspiration +IOL implantation combined with anterior chamber Angle separation) and the control group (treated with phacoemulsification cataract aspiration +IOL implantation combined with trabeculectomy), with 64 cases in each group. The clinical efficacy, optic nerve fiber thickness, anterior chamber depth, anterior chamber Angle, intraocular pressure, BCVA and complications were compared. Result: The time effect, time and intergroup interaction, and intergroup effect of anterior chamber depth, intraocular pressure, anterior chamber Angle, and BCVA in group 2 were significant (P<0.05). The time effect and intergroup effect of optic nerve fiber thickness in the two groups were significant (P<0.05), while there was no difference in time and intergroup interaction (P>0.05). The anterior chamber depth and Angle at time points T1 to T2 and the optic nerve fiber thickness at time point T1 in the observation group were all higher than those in the control group, and the intraocular pressure at time point T1 was lower than that in the control group (P<0.05). The BCVA of the observation group at 1, 3 and 6 months after the operation was all higher than that of the control group (P<0.05). There was no difference in intraocular pressure and optic nerve fiber thickness at time point T2 between the two groups(P>0.05). Conclusion: Phacoemulsification cataract aspiration combined with IOL implantation can effectively control intraocular pressure and improve vision, with minimal retinal damage and a low risk of complications. |
| Key words: Phacoemulsification and capsulorhexis intraocular lens implantation goniosynechialysis acute angle-closure glaucoma cataract patients |
