青白联合术治疗原发性闭角型青光眼合并厚晶状体白内障的疗效观察

发布时间：2018-03-10 13:37

本文选题：超声乳化晶状体摘除并人工晶体植入联合小梁切除术(青白联合术)　切入点：小梁切除术　出处：《南华大学》2010年硕士论文　论文类型：学位论文

【摘要】： 目的:研究青白联合术治疗原发性闭角型青光眼合并厚晶状体白内障的的疗效。资料和方法:我们于2008年1月至2009年3月,对合并晶状体厚度大于5.0mm,具有白内障的原发性闭角型青光眼的住院患者67例(81眼)进行前瞻性研究,将患者随机分为两组:A组33例(40眼)行超声乳化晶状体摘除并人工晶体植入联合小梁切除术(青白联合术)、B组34例(41眼)行小梁切除术。比较观察两组术后视力、眼压、Pavlin法检测的UBM相关指标:中央前房深度(ACD)、房角开放距离500(AOD500)、小梁虹膜角(TIA)、小梁睫状体距离(TCPD)、术后并发症等的变化。结果:术后最终随访时发现:A组术后最佳矫正视力较术前明显提高(P0.05),B组术后最佳矫正视力较术前无明显提高(P0.05);A、B组术后眼压均明显下降(P0.05),A组眼压较B组眼压下降幅度大(P0.05);A组术后中央前房深度(ACD)较术前加深(P0.05)、房角开放距离500(AOD500)较术前增大(P0.05)、小梁虹膜角(TIA)较术前增宽(P0.05)、小梁睫状体距离(TCPD)较术前增大(P0.05);B组术后中央前房深度(ACD)、房角开放距离500(AOD500)、小梁虹膜角(TIA)、小梁睫状体距离(TCPD)与术前相比无显著差异(P0.05);A组术后未出现浅前房、恶性青光眼,B组术后7眼出现浅前房(17.95%)、1眼出现恶性青光眼(2.56%)。结论:1、青白联合术是治疗合并厚晶状体白内障的原发性闭角型青光眼的有效方法。2、青白联合术可从发病机制上解除闭角型青光眼瞳孔晶体阻滞;在增加前房深度,增大房角开放距离500、小梁虹膜角、小梁睫状体距离,改善房水循环,降低眼压方面优于小梁切除术。3、青白联合术可提高合并白内障的原发性闭角型青光眼患者的视力,避免二次手术,为患者节约医疗成本。4、青白联合术可降低小梁切除术后浅前房、恶性青光眼等术后并发症。
[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.
【学位授予单位】：南华大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R779.6

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