两种手术方式治疗开角型青光眼合并白内障的疗效对比

目的：探讨治疗开角型青光眼合并白内障两种手术方式的疗效比较。

方法：将原发性开角型青光眼合并白内障患者分成两组：A组34例34眼行青光眼白内障联合手术(青白联合手术)； B组35例35眼先行小梁切除术，术后6mo后再行白内障手术，即所谓的两阶段手术。监测白内障术后1wk； 3mo的眼压，术后3mo矫正视力、滤过泡情况，并比较两组患者的术中、术后并发症。白内障术后随访时间3～6mo。

结果：A，B两组术后视力均较术前提高，两组比较，差异无统计学意义； A，B两组术后眼压比较，差异无统计学意义； A，B两组术后功能性滤过泡形成情况经方差分析差异无统计学意义(P>0.05)； 两组均未见严重术中术后并发症。

结论：原发性开角型青光眼合并白内障患者选用两阶段手术或青光眼白内障联合手术均可有效控制眼压，改善视功能； 联合手术可避免小梁切除术后的白内障二次手术，使视功能早日得到恢复。

Two surgical treatment methods for open angle glaucoma and cataract

AIM: To compare the curative effects of two surgical treatment methods for open angle glaucoma and cataract patients.

METHODS: Totally 69 patients with primary open angle glaucoma and cataract were divided into two groups: group A and group B. Thirty-four patients(34 eyes)in group A underwent small incision non-phacoemulsification cataract surgery combined with trabeculectomy, just combined operations, 35 patients(35 eyes)in group B underwent small incision non-phacoemulsification cataract surgery beyond 6mo after trabeculectomy, just two stage operations. Postoperative intraocular pressure at 1wk and 3mo, postoperative corrected visual acuity and filtering bleb at 3mo were observed, and intraoperative and postoperative complications were compared. All the patients were followed up for 3-6mo.

RESULTS: All the visual acuity were increased compared with that before surgery in two groups, the difference was not statistically significant. All the intraocular pressure was controlled in two groups, the difference was not statistically significant, and the difference about the filtering bleb was neither statistically significant(P>0.05). There were no serious intraoperative and postoperative complications in two groups.

CONCLUSION: The two stage operations and the combined operations both can control theintraocular pressure and improved visual acuity of open angle glaucoma and cataract. The two stage operations may prevent a second operation for post trabeculectomy cataract, allowing earlier visual rehabilitation.