标题：急性闭角型青光眼合并白内障患者不同手术方式的疗效比较

      作者：王雪飞，覃冬菊，李明哲
    (复旦大学附属浦东医院眼科，上海 201399)

      卷次： 2015年26卷2期

      【摘要】 目的 探讨不同手术方式对急性闭角型青光眼合并白内障患者的临床疗效。方法 根据前房角
粘连关闭程度将60例(60只眼)急性闭角型青光眼合并白内障患者分为三组：房角开放者采用超声乳化吸除术、
人工晶状体植入术；房角粘连小于180°者采用超声乳化吸除术、人工晶状体植入术联合前房角分离术；房角粘连
大于180°者采用超声乳化吸除术、人工晶状体植入术联合小梁切除术。治疗后随访6个月，观察所有患者视力，
前房中央深度，眼压、房角检查结果及并发症。结果 治疗后，所有患者房角粘连均重新开放，三种治疗方案均
改善了患者的平均视力、前房中央深度及眼压，与治疗前比较差异均有统计学意义(P<0.05)；三组并发症的发生
率比较差异均无统计学意义(P>0.05)。结论 超声乳化吸除术、人工晶状体植入术和联合前房角分离术或合小
梁切除术均可改善急性闭角型青光眼合并白内患者的视力状况、眼压水平及前房深度，疗效安全可靠。对于急
性闭角型青光眼青光眼合并白内障患者的手术治疗应结合房角关闭程度选择合适的术式。

      【关键词】 闭角型青光眼；急性；超声乳化术；晶状体植入术；小梁切除术；适应证

      【中图分类号】 R775.2 【文献标识码】 A 【文章编号】 1003—6350（2015）02—0263—03


Efficacy comparation of different ways of surgery in patients with acute angle-closure glaucoma combined
with cataract.
WANG Xue-fei, QIN Dong-ju, LI Ming-zhe. Department of ophthalmology, the Pudong Hospital Affiliated
to Fudan University, Shanghai 201399, CHINA

【Abstract】 Objective To explore the efficacy of different ways of surgery in patients with acute angle-clo-
sure glaucoma combined with cataract. Methods According to the level of the anterior chamber angle closure, 60
cases (60 eyes) of patients with acute angle-closure glaucoma and cataract were divided into three groups: patients
with opened angle (which were performed the phacoemulsification and intraocular lens implantation surgery), the pa-
tients whose goniosynechia was less than 180°(which were performed the surgery of phacoemulsification and intraocu-
lar lens implantation combined with goniosychialysis), and the patients whose goniosynechia was more than 180°
(which were perfomed the phacoemulsification and intraocular lens implantation combined with trabeculectomy). The
visual acuity, central anterior chamber depth, intraocular pressure and complications after the surgery in the three
groups were observed. Results After treatment, all patients' goniosynechia were re-opened. The visual acuity, central
anterior chamber depth and intraocular pressure were all better than those before the treatment (P<0.05). There was no
statistically significant difference in the incidence of complications in the three groups after the treatment (P>0.05).
Conclusion The surgery of phacoemulsification, intraocular lens implantation combined with goniosychialysis or tra-
beculectomy can improve the visual acuity, central anterior chamber depth and intraocular pressure, which is safe and
reliable. The degree of angle closure should be analyzed for the treatment of patients with acute angle-closure glauco-
ma and cataract.

      【Key words】 Angle-closure glaucoma; Acute; Phacoemulsification; Lens implantation; Trabeculectomy; Indi-