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目的:分析评价青光眼白内障联合手术的疗效。方法:对260例(279眼)行青光眼白内障联合手术的病例作回顾性分析,并将病人分为3组。Ⅰ组:白内障囊外摘除联合小梁切除术;Ⅱ组:白内障囊外摘除、人工晶体植入联合小梁切除术;Ⅲ组:超声乳化白内障吸出、人工晶体植入联合小梁切除术;并分析比较3组的术后视力、眼压和并发症。结果:3组病例术后视力≥0.3者分别为16.2％、32.4％和43.5％,术后视力改善率分别为46.6％、70.4％和78.3％;3组术后平均眼压分别为12.72±6.66mmHg(1mmHg=0.133kPa)、13.01±5.26mmHg、12.63±4.66mmHg,与术前相比有显著性差异(P<0.01);Ⅲ组的并发症较其余2组明显减少。结论:青光眼白内障联合手术可有效控制眼压,三联手术能迅速提高视力,其中采用超声乳化白内障吸出技术能大大减少并发症的发生,提高手术的成功率。眼科学报2000;16:102-105。
Objective: To analyze and evaluate the efficacy of combined surgery of glaucoma and cataract. Methods: A retrospective analysis of 260 cases (279 eyes) with glaucoma and cataract combined with surgery was performed. Patients were divided into three groups. Group Ⅰ: extracapsular cataract extraction and trabeculectomy; Group Ⅱ: extracapsular cataract extraction and intraocular lens implantation combined with trabeculectomy; Group Ⅲ: phacoemulsification cataract extraction and intraocular lens implantation combined with trabeculectomy; Analysis and comparison of 3 groups of postoperative visual acuity, intraocular pressure and complications. Results: The postoperative visual acuity ≥ 0.3 of the three groups were 16.2%, 32.4% and 43.5% respectively. The postoperative visual acuity improvement rates were 46.6%, 70.4% and 78.3% respectively. The mean intraocular pressure of the three groups were 12.72 ± 6.66 mmHg (1mmHg = 0.133kPa), 13.01 ± 5.26mmHg, 12.63 ± 4.66mmHg, which were significantly different from those before operation (P <0.01). The complication of group Ⅲ was significantly lower than that of the other two groups. CONCLUSION: Intraocular pressure can be effectively controlled by combined surgery of glaucoma and cataract. Triple surgery can rapidly improve the visual acuity. Phacoemulsification can greatly reduce the incidence of complications and improve the success rate of surgery. Journal of Ophthalmology 2000; 16: 102-105.