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目的分析超声乳化吸出联合房角分离术治疗原发性闭角型青光眼的疗效。方法 2005年10月—2010年10月我院眼科收治的84例原发性青光眼合并白内障患者,随机分为治疗组(42例)和对照组(42例)。治疗组给予超声乳化吸出联合房角分离术,对照组单纯采用超声乳化吸出治疗。术后4、12周用房角镜检查患者房角变化,同时记录眼压变化。结果治疗组100.00%(42/42)房角开放都>180°,都为宽角,没有发生色素减少或者再次房角粘连的情况。对照组42例患者中术后4周仅50.00%(21/42)房角开放>180°,术后12周7.14%(3/42)再次发生房角粘连,同时19.05%(8/42)色素随着时间的延长而减少,差异有统计学意(P<0.05)。术前治疗组和对照组平均眼压分别(28.67±2.11)mmHg、(28.90±1.18)mmHg。术后不用降眼压药治疗组和对照组眼压均值为(22.17±1.98)mmHg、(26.10±1.08)mmHg,正常眼压患者所占比例分别为90.48%(38/42)、42.86%(18/42)差异均有统计学意义(P<0.05)。结论超声乳化吸出联合房角分离术在治疗原发性闭角型青光眼中效果显著,可以重新打开已经闭合的房角,同时在新打开的房角中,巩膜的位置、房角度数、虹膜形态等都比较固定,而且降低眼压的效果较好,还不用同时切除小梁,最终改善患者生活质量、提高治愈率,值得临床推广。
Objective To analyze the therapeutic effect of phacoemulsification combined with room angle separation on primary angle-closure glaucoma. Methods From October 2005 to October 2010, 84 patients with primary glaucoma and cataract treated in our hospital were randomly divided into treatment group (n = 42) and control group (n = 42). The treatment group was given phacoemulsification combined with room angle separation, the control group was treated with phacoemulsification alone. After 4 and 12 weeks, gonocular examination of patients with angle changes, while recording changes in intraocular pressure. Results In the treatment group, 100% (42/42) open angle was> 180 °, all of them were wide-angle. There was no hypochromism or re-corner adhesions. The control group had 42 cases of open angle> 180 ° at 4 weeks postoperatively, and had an angle of> 180 ° at 7.14% (3/42) at 12 weeks postoperatively, while 19.05% (8/42) Pigments decreased with time, the difference was statistically significant (P <0.05). The mean IOP of preoperative treatment group and control group were (28.67 ± 2.11) mmHg and (28.90 ± 1.18) mmHg, respectively. The intraocular pressure (IOP) of the patients who underwent intraocular pressure (IOP) treatment and control group were (22.17 ± 1.98) mmHg and (26.10 ± 1.08) mmHg respectively, and the patients with normal intraocular pressure were 90.48% (38/42) and 42.86% 18/42) difference was statistically significant (P <0.05). Conclusion Phacoemulsification combined with room angle separation in the treatment of primary angle-closure glaucoma has a significant effect, you can reopen the closed angle has been closed, while in the newly opened corner, the location of the sclera, atrial angle, iris morphology And so are relatively fixed, and reduce the effect of intraocular pressure better, do not also remove the trabeculae, and ultimately improve the quality of life of patients and improve the cure rate, it is worth clinical promotion.