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目的观察白内障超声乳化吸除人工晶体植入联合小梁切除术与白内障囊外摘除人工晶体植入联合小梁切除术治疗青光眼合并白内障的临床疗效。方法回顾分析患青光眼白内障在我院行超声乳化白内障吸除人工晶体植入联合小梁切除术(超乳三联术组)的患者74例(92眼),和行白内障囊外摘除人工晶体植入联合小梁切除术(囊外三联术组)的患者40例(52眼),记录手术前、后的视力和眼压,记录手术并发症和滤过泡情况。结果超乳三联术组术后平均眼压为(13.72±2.72)mm Hg,囊外三联术组术后平均眼压(12.92±5.35)mm Hg,较术前显著下降(P<0.01),且两组下降值差异无显著性(t=0.166,P>0.05)。超乳三联术组术后视力显著提高(χ2=18.254,P<0.01),囊外三联术组手术前后视力差异无显著性。术后3个月随访,眼压≥21mm Hg者,超乳三联术组2只眼,囊外三联术组4只眼,两组比较差异无显著性意义(P>0.05)。手术并发症超乳三联术组明显低于囊外三联术组,差异有极显著性意义(P<0.01)。两组术后均无严重并发症发生。结论超声乳化白内障吸除人工晶体植入联合小梁切除术,可安全有效治疗青光眼合并白内障,且效果优于白内障囊外摘除人工晶体植入联合小梁切除术。
Objective To observe the clinical effects of phacoemulsification combined with trabeculectomy combined with extracapsular cataract extraction and intraocular lens implantation combined with trabeculectomy in the treatment of glaucoma and cataract. Methods 74 patients (92 eyes) with glaucoma cataract who underwent phacoemulsification with intraocular lens implantation combined with trabeculectomy (phacoemulsification combined with trabeculectomy) were analyzed retrospectively. All patients underwent extracapsular cataract extraction with intraocular lens implantation Forty patients (52 eyes) with combined trabeculectomy (extracavitary triad surgery) recorded the visual acuity and intraocular pressure before and after surgery, and recorded the complications and filtration bleb. Results The average postoperative IOP was (13.72 ± 2.72) mm Hg in the triple therapy group and 12.92 ± 5.35 mm Hg in the extracavitary triple therapy group, which was significantly lower than that before the operation (P <0.01) There was no significant difference between the two groups (t = 0.166, P> 0.05). The postoperative visual acuity was significantly higher in the triple therapy group (χ2 = 18.254, P <0.01). There was no significant difference in the visual acuity before and after operation in the triple therapy group. After 3 months of follow-up, intraocular pressure ≥ 21mm Hg, hyperplasia triple therapy group 2 eyes, extracapsular triple therapy group 4 eyes, the two groups showed no significant difference (P> 0.05). The complications of surgery in triple therapy group were significantly lower than those in extracapsular triple therapy group, the difference was extremely significant (P <0.01). No serious complications occurred after operation in both groups. Conclusions Phacoemulsification and intraocular lens implantation combined with trabeculectomy are safe and effective in treating glaucoma with cataract and are superior to extracapsular cataract extraction with intraocular lens implantation and trabeculectomy.