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目的评价单纯晶状体超声乳化人工晶状体植入术或再联合小梁切除术治疗伴有白内障的原发慢性闭角型青光眼的疗效。方法30例(44眼)慢性闭角型青光眼,按房角粘连关闭范围分组,分别行单纯超声乳化人工晶状体植入术或超声乳化人工晶状体植入联合小梁切除术。比较两组术后眼压、视力、前房深度以及前房角的变化。结果前房角粘连关闭范围小于180°的,单纯超声乳化人工晶状体植入术,术后眼压94.11%稳定在正常范围;而对前房角粘连关闭范围大于180°者,其中11眼行单纯超声乳化人工晶状体植入术,术后63.64%眼压稳定在正常范围;另16眼行超声乳化人工晶状体植入联合小梁切除术,术后眼压93.75%稳定在正常范围。所有病例,手术后的视力大多有提高,前房深度增加,均未见前房角关闭或粘连范围扩大。结论超声乳化对治疗前房角粘连关闭范围<180°者具有显著效果,而对于前房角粘连关闭范围>180°者联合小梁切除术的疗效高于单纯超声乳化术。
Objective To evaluate the efficacy of simple phacoemulsification and intraocular lens implantation combined with trabeculectomy in the treatment of primary chronic angle closure glaucoma with cataract. Methods Thirty patients (44 eyes) with chronic angle-closure glaucoma were divided into two groups according to the angle of closure of the corner of the room: single phacoemulsification or phacoemulsification and intraocular lens implantation combined with trabeculectomy. The postoperative IOP, visual acuity, anterior chamber depth and anterior chamber angle were compared between the two groups. Results The incidence of anterior chamber angle closure was less than 180 °. The pure intraocular lens implantation was performed. The intraocular pressure (IOP) was 94.11% stable within the normal range. For the anterior chamber angle closure range greater than 180 °, 11 eyes were simple The phacoemulsification and intraocular lens implantation were performed with 63.64% intraocular pressure (IOP) stabilized within the normal range. The other 16 eyes underwent phacoemulsification and intraocular lens implantation combined with trabeculectomy. The postoperative IOP was stable in the normal range. In all cases, most of the visual acuity after surgery was improved, and the depth of the anterior chamber was increased. No anterior chamber angle was closed or the area of adhesion was enlarged. Conclusion Phacoemulsification has a significant effect on the treatment of anterior chamber angle closure in the range of 180 °, while the effect of combined trabeculectomy for the anterior chamber angle closure range of 180 ° is higher than that of simple phacoemulsification.