本文選題：超聲乳化晶狀體摘除并人工晶體植入聯(lián)合小梁切除術(shù)(青白聯(lián)合術(shù))　切入點(diǎn)：小梁切除術(shù)　出處：《南華大學(xué)》2010年碩士論文　論文類型：學(xué)位論文

【摘要】： 目的:研究青白聯(lián)合術(shù)治療原發(fā)性閉角型青光眼合并厚晶狀體白內(nèi)障的的療效。 資料和方法:我們于2008年1月至2009年3月,對(duì)合并晶狀體厚度大于5.0mm,具有白內(nèi)障的原發(fā)性閉角型青光眼的住院患者67例(81眼)進(jìn)行前瞻性研究,將患者隨機(jī)分為兩組:A組33例(40眼)行超聲乳化晶狀體摘除并人工晶體植入聯(lián)合小梁切除術(shù)(青白聯(lián)合術(shù))、B組34例(41眼)行小梁切除術(shù)。比較觀察兩組術(shù)后視力、眼壓、Pavlin法檢測(cè)的UBM相關(guān)指標(biāo):中央前房深度(ACD)、房角開(kāi)放距離500(AOD500)、小梁虹膜角(TIA)、小梁睫狀體距離(TCPD)、術(shù)后并發(fā)癥等的變化。 結(jié)果:術(shù)后最終隨訪時(shí)發(fā)現(xiàn):A組術(shù)后最佳矯正視力較術(shù)前明顯提高(P0.05),B組術(shù)后最佳矯正視力較術(shù)前無(wú)明顯提高(P0.05);A、B組術(shù)后眼壓均明顯下降(P0.05),A組眼壓較B組眼壓下降幅度大(P0.05);A組術(shù)后中央前房深度(ACD)較術(shù)前加深(P0.05)、房角開(kāi)放距離500(AOD500)較術(shù)前增大(P0.05)、小梁虹膜角(TIA)較術(shù)前增寬(P0.05)、小梁睫狀體距離(TCPD)較術(shù)前增大(P0.05);B組術(shù)后中央前房深度(ACD)、房角開(kāi)放距離500(AOD500)、小梁虹膜角(TIA)、小梁睫狀體距離(TCPD)與術(shù)前相比無(wú)顯著差異(P0.05);A組術(shù)后未出現(xiàn)淺前房、惡性青光眼,B組術(shù)后7眼出現(xiàn)淺前房(17.95%)、1眼出現(xiàn)惡性青光眼(2.56%)。 結(jié)論:1、青白聯(lián)合術(shù)是治療合并厚晶狀體白內(nèi)障的原發(fā)性閉角型青光眼的有效方法。2、青白聯(lián)合術(shù)可從發(fā)病機(jī)制上解除閉角型青光眼瞳孔晶體阻滯;在增加前房深度,增大房角開(kāi)放距離500、小梁虹膜角、小梁睫狀體距離,改善房水循環(huán),降低眼壓方面優(yōu)于小梁切除術(shù)。3、青白聯(lián)合術(shù)可提高合并白內(nèi)障的原發(fā)性閉角型青光眼患者的視力,避免二次手術(shù),為患者節(jié)約醫(yī)療成本。4、青白聯(lián)合術(shù)可降低小梁切除術(shù)后淺前房、惡性青光眼等術(shù)后并發(fā)癥。
[Abstract]:Objective: to study the effect of combined Qingbai surgery on primary angle-closure glaucoma with thick lens cataract. Materials and methods: from January 2008 to March 2009, we carried out a prospective study of 67 patients (81 eyes) with primary angle-closure glaucoma with cataract, whose lens thickness was greater than 5.0 mm. The patients were randomly divided into two groups: group A (n = 33, n = 40) underwent phacoemulsification and intraocular lens implantation combined with trabeculectomy (group B, n = 34, trabeculectomy, n = 41). Intraocular pressure Pavlin's method was used to detect UBM: the depth of anterior chamber, the open distance of anterior chamber, the trabecular iris angle, the distance of trabecular ciliary body, the postoperative complications, and so on. Results: at the final follow-up, we found that the best corrected visual acuity (BCVA) in group A was significantly higher than that in group B (P 0.05). The intraocular pressure in group A was significantly lower than that in group B (P 0.05). The intraocular pressure in group A was significantly lower than that in group B. In group A, the depth of central anterior chamber (ACD) was deeper than that in group A (P 0.05), and the distance between anterior chamber angle and anterior chamber was higher than that before operation (P 0.05), the trabecular iris angle (TIAA) was wider than that before operation (P 0.05), the distance between trabecular ciliary body and central anterior chamber in group B was higher than that in group B (P 0.05), and the anterior chamber depth of anterior chamber in group B was significantly higher than that in group B. In group A, there was no significant difference in angle opening distance (500), trabecular iris angle (TIAA) and trabecular ciliary body distance (TCPD). In group B, superficial anterior chamber was found in 7 eyes and malignant glaucoma was found in 1 eye. Conclusion the combined operation of white and white is an effective method for the treatment of primary angle-closure glaucoma complicated with thick lens cataract. The combined operation can relieve the pupillary lens block of angle-closure glaucoma from the pathogenetic mechanism and increase the depth of anterior chamber. Increasing the open distance of atrial angle 500, trabecular iris angle, trabecular ciliary body distance, improving aqueous humor circulation, reducing intraocular pressure is better than trabeculectomy. 3. The combined operation of white and green can improve the visual acuity of patients with primary angle-closure glaucoma complicated with cataract. To avoid the secondary operation and save the medical cost of the patients. The combined operation can reduce the postoperative complications such as shallow anterior chamber and malignant glaucoma after trabeculectomy.
【學(xué)位授予單位】：南華大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類號(hào)】：R779.6

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