青光眼滤过术后白内障患者行超声乳化联合人工晶状体植入术毕前房注射地塞米松的临床疗效

发布时间：2018-12-12 02:52

【摘要】：目的评价青光眼滤过术后白内障患者行超声乳化联合人工晶状体植入术毕前房注射地塞米松的临床疗效。方法选取青光眼滤过术后白内障患者98例(120眼),由同一医师进行白内障超声乳化联合人工晶状体植入术。所有患者随机分组,对照组48例(60眼)术毕给予地塞米松注射液0.5 m L(2.5 mg)球结膜下注射;试验组50例(60眼)术毕前房内注射0.1m L(0.5 mg)地塞米松注射液。观察并比较两组患者手术后最佳矫正视力、前房反应、眼压、角膜内皮细胞计数、六角形细胞比率的差异。结果青光眼滤过术后白内障超声乳化联合人工晶状体植入术后1 d、3 d最佳矫正视力试验组比对照组效果更好,2组比较差异有统计学意义(P0.05),术后1周最佳矫正视力两组间差异无统计学意义(P0.05);对照组与试验组术前,术后1 d、3 d、1周、1个月、3个月眼压组间比较差异均无统计学意义(均为P0.05);对照组与试验组术后1 d、3 d、1周前房炎症反应组间差异有统计学意义(均为P0.05),试验组眼前房炎症反应较轻;对照组与试验组术后3 d、1周、1个月角膜内皮细胞密度、六角形细胞百分比及变异系数组间比较差异均有统计学意义(均为P0.05),对照组较试验组术后细胞密度明显降低,六角形细胞百分比下降,变异系数增高。结论青光眼滤过术后白内障超声乳化联合人工晶状体植入术毕前房注射地塞米松注射液是安全有效的,对术后短期内获得最佳矫正视力、减轻前房反应、减少角膜内皮细胞的丢失具有积极的临床意义。
[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.
【作者单位】：石河子大学医学院第一附属医院眼科;
【基金】：石河子大学医学院第一附属医院院级课题(编号:SS2011-074)~~
【分类号】：R779.6

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