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目的 比较超声乳化白内障摘除联合眼内窥镜下睫状体光凝210度和240度范围对难治性青光眼眼压下降幅度的差异.设计比较性病例系列.研究对象北京同仁医院70例(70眼)难治性青光眼患者.方法 70眼随机分为光凝范围210度组35例,240度组35例.所有患者透明角膜切口超声乳化白内障摘除人工晶状体植入联合内窥镜下睫状体光凝与房角分离.术后平均随访(21.69±8.93)个月.主要指标眼压、降眼压药物使用数量.结果 术前210度组与240组平均眼压分别为(26.13±10.58)mmHg、(24.85±10.78)mmHg(P=0.620),末次随访时平均眼压分别为(18.31±6.62)mmHg、(16.26±4.41)mmHg(P=0.131),眼压下降幅度分别为(7.81±12.55) mmHg与(8.57±11.40)mmHg.术前210度组与240组平均用降眼压药物数量分别为(2.71±1.66)种、(2.40±1.65)种(P=0.429),末次随访时用降眼压药物数量分别为(0.46±0.98)种、(0.34±0.80)种(P=0.595).两组术中、术后无严重并发症发生.结论 超声乳化白内障摘除人工晶状体植入联合内窥镜下睫状体光凝光凝范围210度与240度对眼压控制无明显差异.“,”Objective To compare the difference of lowering effect by phacoemulsification cataract extraction combined with endoscopic cyclophotocoagulation (ECP) between 210 degree and 240 degree treatment.Design Comparative case series.Participants 70 cases (70 eyes) with refractory glaucoma in Beijing Tongren Hospital were included.Methods 70 eyes were randomly divided into two groups,35 cases were undergoing 210 and 240 degree ECP treatment respectively.All the patients were selected by clear corneal incision phacoemulsification (PE) cataract extraction combined with ECP and goniosynechialysis.The average follow-up period was (21.69± 8.93) months.Main Outcome Measures Intraocular pressure (IOP) and IOP lowering pressure medications.Result Preoperative IOP was (26.13±10.58)mmHg in group 210 degree and (24.85±10.78)mmHg in group 240 degree (P=0.620).IOP decreased (7.81±12.55) mmHg and (8.57±11.40)mmHg respectively in the two groups at last follow-up(P=0.131).The average number of medications was (2.71± 1.66)in group 210 degree and (2.40±1.65) in group 240 degree before operation(P=0.429),which decreased to (0.46±0.98) in group 210 degree and (0.34±0.80) in group 240 degree at last follow-up (P=0.595).No serious complication during the operation was observed.Conclusion There was no statistical significance in the control of IOP between the 210 degree group and 240 degree group by phacoemulsification cataract extraction combined with ECP.