超声乳化联合人工晶体植入治疗继发性闭角型青光眼疗效观察
|
摘要
目的探讨超声乳化白内障吸除术联合人工晶状体植入术治疗晶状体悬韧带异常继发性闭角型青光眼的临床效果。方法选取2016年1月—2018年10月中山大学附属东华医院收治的晶状体悬韧带异常继发性闭角型青光眼患者85例,按悬韧带断裂范围、松弛程度分Ⅰ组(n=24)、Ⅱ组(n=36)、Ⅲ组(n=25)。Ⅰ组行超声乳化白内障吸除术联合人工晶状体植入术、Ⅱ组行超声乳化白内障吸除术联合人工晶状体植入术及张力环、Ⅲ组行超声乳化白内障吸除术联合前段玻璃体切除术及人工晶状体悬吊术。观察并发症发生率,比较术前、术后1周、术后3个月视力、眼压及中央前房深度。结果各组术前、术后1周、术后3个月视力经单因素方差分析,差异有统计学意义(P<0.05);术后3个月3组眼压低于术前,中央前房深度高于术前(P均<0.05);Ⅰ组无并发症发生、Ⅱ组房角劈裂1例,Ⅲ组人工晶状体倾斜1例。结论超声乳化白内障吸除术联合人工晶状体植入术治疗晶状体悬韧带异常继发性闭角型青光眼并发症少,有助于降低眼压,增加中央前房深度,恢复视力。
Objective To investigate the clinical effect of phacoemulsification and intraocular lens implantation in the treatment of secondary angle-closure glaucoma with abnormal lens suspensory ligament. Methods From January 2016 to October 2018, 85 patients with abnormal angle-closure glaucoma in the lens suspensory ligament in Donghua Hospital, Sun Yat-sen University were selected. According to the extent of rupture of the suspensory ligament and the degree of relaxation, the patients were divided into three groups: groupⅠ(n=24), groupⅡ(n=36), groupⅢ(n=25). GroupⅠunderwent phacoemulsification combined with intraocular lens implantation; groupⅡunderwent phacoemulsification combined with intraocular lens implantation and tension ring; groupⅢunderwent phacoemulsification combined with anterior vitrectomy and intraocular lens suspension. The incidence of complications were observed, and visual acuity, intraocular pressure and central anterior chamber depth were compared before operation and 1 week after operation, 3 months after operation. Results One-way analysis of variance showed that visual acuities in the three groups were all improved after operation(P<0.05). Compared with the preoperative data, the intraocular pressures decreased and central anterior chamber depths increased 3 months after operation in the three groups(all P<0.05). No complications were found in groupⅠ, and there was 1 case of angle splitting in groupⅡand 1 case of intraocular lens tilt in groupⅢ. Conclusions Phacoemulsification combined with intraocular lens implantation for the treatment of secondary angle-closure glaucoma with abnormal lens suspensory ligament has fewer complications and helps to reduce intraocular pressure, increase central anterior chamber depth,and restore vision.
Objective To investigate the clinical effect of phacoemulsification and intraocular lens implantation in the treatment of secondary angle-closure glaucoma with abnormal lens suspensory ligament. Methods From January 2016 to October 2018, 85 patients with abnormal angle-closure glaucoma in the lens suspensory ligament in Donghua Hospital, Sun Yat-sen University were selected. According to the extent of rupture of the suspensory ligament and the degree of relaxation, the patients were divided into three groups: groupⅠ(n=24), groupⅡ(n=36), groupⅢ(n=25). GroupⅠunderwent phacoemulsification combined with intraocular lens implantation; groupⅡunderwent phacoemulsification combined with intraocular lens implantation and tension ring; groupⅢunderwent phacoemulsification combined with anterior vitrectomy and intraocular lens suspension. The incidence of complications were observed, and visual acuity, intraocular pressure and central anterior chamber depth were compared before operation and 1 week after operation, 3 months after operation. Results One-way analysis of variance showed that visual acuities in the three groups were all improved after operation(P<0.05). Compared with the preoperative data, the intraocular pressures decreased and central anterior chamber depths increased 3 months after operation in the three groups(all P<0.05). No complications were found in groupⅠ, and there was 1 case of angle splitting in groupⅡand 1 case of intraocular lens tilt in groupⅢ. Conclusions Phacoemulsification combined with intraocular lens implantation for the treatment of secondary angle-closure glaucoma with abnormal lens suspensory ligament has fewer complications and helps to reduce intraocular pressure, increase central anterior chamber depth,and restore vision.
引文
[1]张思毅,高炜,陈莲,等.超声乳化白内障吸除术与人工晶状体植入术联合治疗急性闭角型青光眼患者的疗效及安全性评价[J].中国医刊,2016,51(11):69-72.
[2]王海山.白内障超声乳化人工晶体植入术联合巩膜隧道内小梁切除术治疗合并白内障的急性闭角型青光眼疗效观察[J].河北医药,2015,35(26):418-419.
[3] Raj P, Kumar K, Chandnani N, et al. Secondary AngleClosure Glaucoma Due to Posterior Synechiae of Iris Following Combined Phacoemulsification and 23-Gauge Transconjunctival Vitrectomy[J]. Semin Ophthalmol, 2017,32(5):537-542.
[4]成磊,刘杏,钟毅敏,等.显微超声乳化白内障吸除联合人工品状体植入术治疗晶状体悬韧带异常继发性闭角型青光眼疗效分析[J].中华显微外科杂志,2016,39(4):404-407.
[5]徐晓双,万修华,张景尚,等.3种不同手术方式治疗晶状体悬韧带异常继发性闭角型青光眼疗效比较[J].检验医学与临床,2018,15(12):1765-1769.
[6] Nie L, Fang A, Pan W, et al. Prospective Study on ExPRESS Implantation Combined with Phacoemulsification in Primary Angle-Closure Glaucoma Coexisting Cataract:3-Year Results[J]. Curr Eye Res, 2018,43(8):1045-1051.
[7]韩兆玲.超声乳化白内障吸除联合人工晶体植入术对原发性闭角型青光眼患者视力及眼压的影响研究[J].空军医学杂志,2017,33(1):61-62.
[8]王立涛.超声乳化吸除联合后房型人工晶状体植入术对闭角型青光眼的治疗作用[J].中国现代手术学杂志,2016,20(2):152-154.
[2]王海山.白内障超声乳化人工晶体植入术联合巩膜隧道内小梁切除术治疗合并白内障的急性闭角型青光眼疗效观察[J].河北医药,2015,35(26):418-419.
[3] Raj P, Kumar K, Chandnani N, et al. Secondary AngleClosure Glaucoma Due to Posterior Synechiae of Iris Following Combined Phacoemulsification and 23-Gauge Transconjunctival Vitrectomy[J]. Semin Ophthalmol, 2017,32(5):537-542.
[4]成磊,刘杏,钟毅敏,等.显微超声乳化白内障吸除联合人工品状体植入术治疗晶状体悬韧带异常继发性闭角型青光眼疗效分析[J].中华显微外科杂志,2016,39(4):404-407.
[5]徐晓双,万修华,张景尚,等.3种不同手术方式治疗晶状体悬韧带异常继发性闭角型青光眼疗效比较[J].检验医学与临床,2018,15(12):1765-1769.
[6] Nie L, Fang A, Pan W, et al. Prospective Study on ExPRESS Implantation Combined with Phacoemulsification in Primary Angle-Closure Glaucoma Coexisting Cataract:3-Year Results[J]. Curr Eye Res, 2018,43(8):1045-1051.
[7]韩兆玲.超声乳化白内障吸除联合人工晶体植入术对原发性闭角型青光眼患者视力及眼压的影响研究[J].空军医学杂志,2017,33(1):61-62.
[8]王立涛.超声乳化吸除联合后房型人工晶状体植入术对闭角型青光眼的治疗作用[J].中国现代手术学杂志,2016,20(2):152-154.