本文選題：超聲乳化吸出術(shù) + 房角分離術(shù)��； 參考：《第三軍醫(yī)大學(xué)》2012年碩士論文

【摘要】：目的 比較超聲乳化白內(nèi)障吸除術(shù)(Phacoemulsification,PHACO)聯(lián)合兩種不同方式的房角粘連分離術(shù)(Goniosynechialysis GSL)治療原發(fā)性閉角型青光眼(PrimaryAngle-Closure Glaucoma,PACG)合并白內(nèi)障的臨床效果。 研究對象和方法 原發(fā)性閉角型青光眼合并白內(nèi)障患者24例(32眼)，術(shù)前均在使用不同數(shù)量的抗青光眼藥物，隨機分成A組(撕囊前行房角分離)17例21眼；B組(皮質(zhì)吸除后行房角分離)7例11眼，均施行白內(nèi)障超聲乳化吸除聯(lián)合房角粘連分離術(shù),觀察兩組患者術(shù)前、術(shù)后1月、3月、6月、12月的視力、眼壓、房角開放程度、前房中央深度的變化。 結(jié)果 A組和B組術(shù)前平均最佳矯正視力(Logmar視力)分別為1.13±0.75和0.93±0.50，無統(tǒng)計學(xué)意義(p0.05)。術(shù)后1月、3月、6月和12月，A組的平均最佳矯正視力為0.57±0.33,0.42±0.24,0.30±0.23,0.35±0.28，B組的為0.68±0.60,0.38±0.15,0.40±0.17,0.33±0.13,and0.37±0.06，術(shù)后兩組視力均較術(shù)前有明顯提升，然而兩組在同一時間點無顯著差異。A組和B組術(shù)前平均Goldman眼壓分別為35.67±12.31mmHg和31.64±15.06mmHg，術(shù)后1月、3月、6月和12月，兩組的眼壓均明顯下降，但兩組同一時間點數(shù)據(jù)之間無統(tǒng)計學(xué)意義。A組和B組術(shù)前的平均中央前房深度為：1.56±0.37mm和1.72±0.35mm。而在術(shù)后1月、3月、6月、12月，兩組中央前房深度均較術(shù)前有明顯加深，但兩組平均中央前房深度在各個觀察時間點間無統(tǒng)計學(xué)差異。術(shù)后1年，兩組的手術(shù)完全成功率非別為86.0%和90.0%，兩組的部分成功率分別為9.5%和10.0%，兩組失敗率分別為A組4.8%，B組無失敗病例。A組術(shù)前使用抗青光眼藥物種類為2.05±0.74，1眼房角分離術(shù)后仍需行小梁切除術(shù)，2眼房角分離術(shù)后仍需抗青光眼藥物治療才能將眼壓控制在正常范圍。B組術(shù)前使用抗青光眼藥物種類為2.18±0.87種，1眼術(shù)后仍需抗青光眼藥物治療才能將眼壓控制在正常范圍。在術(shù)后各個時間觀察點，A組房角在術(shù)后各個時間點開放較充分，而B組有4眼術(shù)后復(fù)查時發(fā)現(xiàn)房角狹窄。 結(jié)論 對于閉角型青光眼合并白內(nèi)障患者，不同方式行房角分離手術(shù)均能顯著提高患者的視力、降低眼壓和加深前房，但根據(jù)術(shù)后房角開放程度，A組手術(shù)方式較B組能取得更好的手術(shù)效果。
[Abstract]:Purpose To compare the clinical effect of phacoemulsification- PHACO combined with two different methods of angle adhesions separation (Goniosynechialysis GSL) in the treatment of primary angle-closure glaucoma with primary Angle-Closure Glaucoma PACG. Research objects and methods Twenty-four patients with primary angle-closure glaucoma complicated with cataract were treated with different amount of antiglaucoma drugs before operation. They were randomly divided into group A (17 cases 21 eyes with anterior chamber angle separation) and group B (7 cases 11 eyes with angle separation after cortical aspiration). All patients were treated with phacoemulsification combined with separation of atrial angle adhesion. The changes of visual acuity, intraocular pressure, angle opening degree and anterior chamber central depth were observed before operation, 1 month, 3 months, 6 months and 12 months after operation. Result The mean preoperative best corrected visual acuity (BCVA) of group A and group B were 1.13 鹵0.75 and 0.93 鹵0.50, respectively. The average corrected visual acuity of group A was 0.57 鹵0.33 鹵0.42 鹵0.24 鹵0.30 鹵0.23 鹵0.35 鹵0.28 in 1 month, 3 months, 6 months and 12 months after operation. The visual acuity of group B was 0.68 鹵0.600.38 鹵0.150.40 鹵0.17 鹵0.33 鹵0.13 and 0.37 鹵0.06, respectively. However, there was no significant difference between the two groups at the same time. The preoperative mean intraocular pressure of group A and group B was 35.67 鹵12.31mmHg and 31.64 鹵15.06 mmHg, respectively. The IOP of group A and group B decreased significantly at 1 month, 3 months, 6 months and 12 months after operation. However, there was no statistical significance between the two groups at the same time point. The mean anterior chamber depth before operation in group A and group B was 1. 56 鹵0.37mm and 1. 72 鹵0. 35mm. However, the depth of the central anterior chamber in the two groups was significantly deeper than that before operation in 1 month, 3 months, 6 months and 12 months after operation, but there was no significant difference in the mean central anterior chamber depth between the two groups at different observation time points. One year after surgery, The total success rate of operation was 86.0% and 90.0% in both groups, and the partial success rate was 9.5% and 10.0 in both groups, respectively. The failure rate of two groups was 4.8B group without failure cases. Group A was treated with anti-glaucoma drugs before operation 2.05 鹵0.74m 1 eye after atrial angle separation. Still need trabeculectomy 2 eyes after angle separation still need antiglaucoma drug treatment to control IOP in normal range. Group B before the use of anti-glaucoma drugs 2.18 鹵0.87 kinds of glaucoma drugs still need to be treated after 1 eye Can control IOP in normal range. The angle of atrium in group A was more open at each time point after operation, while in group B, 4 eyes were found to have stenosis after operation. Conclusion For angle-closure glaucoma patients with cataract, different methods of angle separation surgery can significantly improve the visual acuity, reduce intraocular pressure and deepen the anterior chamber. But according to the degree of atrial angle opening, group A can get better results than group B.
【學(xué)位授予單位】：第三軍醫(yī)大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R779.66

【參考文獻】

相關(guān)期刊論文 前8條

1 曾流芝;劉洪;;白內(nèi)障超聲乳化吸出聯(lián)合房角分離術(shù)治療原發(fā)性閉角型青光眼的房角變化[J];第三軍醫(yī)大學(xué)學(xué)報;2009年02期

2 李世宏;葉劍;尹小磊;;超聲乳化人工晶體植入在白內(nèi)障膨脹期原發(fā)性房角關(guān)閉治療的長期觀察[J];第三軍醫(yī)大學(xué)學(xué)報;2009年20期

3 朱思泉,王寧利,張紅言,余秋容,李奇根;白內(nèi)障超聲乳化摘除聯(lián)合房角粘連分離術(shù)治療青光眼合并白內(nèi)障的臨床研究[J];首都醫(yī)科大學(xué)學(xué)報;2005年03期

4 張齡潔;伍海建;管濤;王超軍;;晶狀體超聲乳化聯(lián)合房角分離術(shù)在原發(fā)性急性房角關(guān)閉中的應(yīng)用[J];眼外傷職業(yè)眼病雜志(附眼科手術(shù));2008年10期

5 王寧利,歐陽潔,周文炳,賴銘瑩,葉天才,曾明兵,陳靜嫦;中國人閉角型青光眼房角關(guān)閉機制的研究[J];中華眼科雜志;2000年01期

6 鄒吉新,張繁友,張立軍,王麗晶,黃紅深;激光周邊虹膜成形術(shù)治療虹膜切除術(shù)后暗室俯臥試驗陽性的原發(fā)性閉角型青光眼[J];中華眼科雜志;2002年12期

7 葉天才，毛文書，陸道平，彭壽雄，，陳秀琦，許京京，于強，程冰，朱斯平;原發(fā)性閉角型青光眼易感眼的簡易篩選方法比較[J];中華眼科雜志;1995年05期

8 林明楷,葛堅,劉奕志,卓業(yè)鴻,藍育青,陳慧怡;超聲乳化白內(nèi)障吸除術(shù)治療白內(nèi)障合并繼發(fā)性閉角型青光眼[J];中山醫(yī)科大學(xué)學(xué)報;2002年03期

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