【摘要】：目的:探討兩種術(shù)式對(duì)原發(fā)性閉角型青光眼患者眼表的影響。方法:選擇合并白內(nèi)障的原發(fā)性閉角型青光眼患者60例60眼,隨機(jī)分成A、B兩組,各30例30眼,A組行小梁切除聯(lián)合白內(nèi)障超聲乳化+人工晶狀體植入術(shù),B組行小梁切除術(shù),比較兩組患者術(shù)前1d和術(shù)后1wk,1、3mo的非接觸性首次淚膜破裂時(shí)間(NIKf-BUT)、淚液分泌試驗(yàn)(SⅠt)和角結(jié)膜麗絲胺綠染色評(píng)分。結(jié)果:(1)NIKf-BUT:兩組患者術(shù)后和術(shù)前相比均縮短,差異有顯著統(tǒng)計(jì)學(xué)意義(均P0.01);A組與B組相比,術(shù)后1wk、1mo和3mo時(shí),A組的NIKf-BUT(2.78±1.44、3.72±0.94、5.95±0.81s)明顯短于B組(4.54±1.68、5.14±1.01、8.34±1.15s),差異有統(tǒng)計(jì)學(xué)意義(t=-4.341、-5.636、-9.29,均P0.05);(2)SⅠt:兩組患者術(shù)后1wk、1mo和術(shù)前1d相比均減少,差異有統(tǒng)計(jì)學(xué)意義(均P0.01);A組與B組相比,術(shù)后1 wk和1 mo時(shí),A組的SⅠt(8.57±2.47、8.10±2.41mm)少于B組(10.07±2.07、9.53±2.29mm),差異有統(tǒng)計(jì)學(xué)意義(t=-2.5 4 9、-2.636,均P0.05)。(3)角結(jié)膜麗絲胺綠染色評(píng)分:兩組患者術(shù)后和術(shù)前相比均升高,差異有統(tǒng)計(jì)學(xué)意義(均P0.01);A組與B組相比,術(shù)后1wk和1mo時(shí),A組的角結(jié)膜麗絲胺綠染色評(píng)分(3.50±1.17、2.27±0.91分)高于B組(2.50±1.33、1.33±0.88分),差異均有統(tǒng)計(jì)學(xué)意義(t=3.092、4.036,均P0.01)。結(jié)論:小梁切除聯(lián)合白內(nèi)障超聲乳化+人工晶狀體植入術(shù)對(duì)原發(fā)性閉角型青光眼患者眼表的影響較小梁切除術(shù)大,更需減少術(shù)中眼表?yè)p傷,防控術(shù)后淚膜不穩(wěn)定。
[Abstract]:Objective: to investigate the effect of two surgical methods on the ocular surface of patients with primary angle-closure glaucoma. Methods: 60 cases (60 eyes) of primary angle-closure glaucoma complicated with cataract were randomly divided into two groups: group A (30 cases, 30 eyes), group A (trabeculectomy, combined with phacoemulsification and intraocular lens implantation), group B (group B, trabeculectomy). The time of first lacrimal rupture (NIKf-BUT), lacrimal secretion test (S 鈪，

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