【摘要】：目的評價(jià)青光眼濾過術(shù)后白內(nèi)障患者行超聲乳化聯(lián)合人工晶狀體植入術(shù)畢前房注射地塞米松的臨床療效。方法選取青光眼濾過術(shù)后白內(nèi)障患者98例(120眼),由同一醫(yī)師進(jìn)行白內(nèi)障超聲乳化聯(lián)合人工晶狀體植入術(shù)。所有患者隨機(jī)分組,對照組48例(60眼)術(shù)畢給予地塞米松注射液0.5 m L(2.5 mg)球結(jié)膜下注射;試驗(yàn)組50例(60眼)術(shù)畢前房內(nèi)注射0.1m L(0.5 mg)地塞米松注射液。觀察并比較兩組患者手術(shù)后最佳矯正視力、前房反應(yīng)、眼壓、角膜內(nèi)皮細(xì)胞計(jì)數(shù)、六角形細(xì)胞比率的差異。結(jié)果青光眼濾過術(shù)后白內(nèi)障超聲乳化聯(lián)合人工晶狀體植入術(shù)后1 d、3 d最佳矯正視力試驗(yàn)組比對照組效果更好,2組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05),術(shù)后1周最佳矯正視力兩組間差異無統(tǒng)計(jì)學(xué)意義(P0.05);對照組與試驗(yàn)組術(shù)前,術(shù)后1 d、3 d、1周、1個(gè)月、3個(gè)月眼壓組間比較差異均無統(tǒng)計(jì)學(xué)意義(均為P0.05);對照組與試驗(yàn)組術(shù)后1 d、3 d、1周前房炎癥反應(yīng)組間差異有統(tǒng)計(jì)學(xué)意義(均為P0.05),試驗(yàn)組眼前房炎癥反應(yīng)較輕;對照組與試驗(yàn)組術(shù)后3 d、1周、1個(gè)月角膜內(nèi)皮細(xì)胞密度、六角形細(xì)胞百分比及變異系數(shù)組間比較差異均有統(tǒng)計(jì)學(xué)意義(均為P0.05),對照組較試驗(yàn)組術(shù)后細(xì)胞密度明顯降低,六角形細(xì)胞百分比下降,變異系數(shù)增高。結(jié)論青光眼濾過術(shù)后白內(nèi)障超聲乳化聯(lián)合人工晶狀體植入術(shù)畢前房注射地塞米松注射液是安全有效的,對術(shù)后短期內(nèi)獲得最佳矯正視力、減輕前房反應(yīng)、減少角膜內(nèi)皮細(xì)胞的丟失具有積極的臨床意義。
[Abstract]:Objective to evaluate the clinical effect of phacoemulsification combined with intraocular lens implantation (IOL) in patients with cataract after glaucoma filtration. Methods 98 cases (120 eyes) of cataract after glaucoma filtration were selected. Phacoemulsification combined with intraocular lens implantation was performed by the same doctor. All patients were randomly divided into control group (48 cases (60 eyes) received dexamethasone injection 0.5 m L (2.5 mg) subconjunctival injection; In the test group, 50 cases (60 eyes) were injected with 0. 1m L (0. 5 mg) dexamethasone injection at the end of operation. The best corrected visual acuity, anterior chamber reaction, intraocular pressure, corneal endothelial cell count and the ratio of hexagonal cells were observed and compared between the two groups. Results the effect of phacoemulsification combined with intraocular lens implantation was better in the experimental group than in the control group 1 d after glaucoma filtration surgery (P0.05). There was no significant difference in the best corrected visual acuity between the two groups 1 week after operation (P0.05). There was no significant difference in IOP between the control group and the experimental group before operation, 1 day after operation, 1 month, 3 months after operation (P0.05). There was a significant difference in anterior chamber inflammation between the control group and the experimental group on the 1st day after operation (P0.05), and the anterior chamber inflammation was mild in the test group. There were significant differences in corneal endothelial cell density, percentage of hexagonal cells and coefficient of variation between the control group and the experimental group at 1 week and 1 month postoperatively (P0.05). Compared with the control group, the cell density, the percentage of hexagonal cells and the coefficient of variation increased significantly in the control group. Conclusion phacoemulsification combined with intraocular lens implantation after glaucoma filtration surgery is safe and effective for obtaining the best corrected visual acuity and alleviating the anterior chamber reaction in the short period after glaucoma filtration surgery by injecting dexamethasone injection into anterior chamber. Reducing the loss of corneal endothelial cells has positive clinical significance.
【作者單位】： 石河子大學(xué)醫(yī)學(xué)院第一附屬醫(yī)院眼科;
【基金】：石河子大學(xué)醫(yī)學(xué)院第一附屬醫(yī)院院級課題(編號:SS2011-074)~~
【分類號】：R779.6

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