超声乳化白内障吸出联合Ex-PRESS青光眼引流器植入术治疗合并白内障的原发性开角型青光眼

发布时间：2019-04-22 20:05

【摘要】：目的探讨超声乳化白内障吸出联合Ex-PRESS青光眼引流器植入术治疗合并白内障的原发性开角型青光眼的临床效果及安全性。方法采用前瞻性、随机、单盲、平行对照试验,选取合并白内障的原发性开角型青光眼患者,试验组入选20例(20眼),行超声乳化白内障吸出联合Ex-PRESS青光眼引流器植入术;对照组入选20例(20眼),行超声乳化白内障吸出联合小梁切除术,共观察12周。观察的指标包括眼压、视力、滤过泡、术后并发症等。结果术后12周,试验组眼压从(28.7±6.9)mmHg(1 kPa=7.5 mmHg)降至(11.3±2.5)mmHg,对照组从(29.1±7.1)mmHg降至(12.0±2.5)mmHg,两组病例术后眼压均明显降低(均为P0.01),但在术后1 d、1周、4周时,试验组眼压较对照组更低(均为P0.05)。至术后12周时,试验组手术完全成功率(95%)明显高于对照组(70%),差异有统计学意义(P0.05)。试验组1眼出现引流器管口阻塞;对照组术后低眼压3眼、前房出血3眼、非功能性滤过泡2眼、恶性青光眼1眼。结论超声乳化白内障吸出联合Ex-PRESS青光眼引流器植入术治疗合并白内障的原发性开角型青光眼是安全且有效的。
[Abstract]:Objective to evaluate the clinical efficacy and safety of phacoemulsification cataract extraction combined with Ex-PRESS glaucoma drainage in the treatment of primary open angle glaucoma with cataract. Methods A prospective, randomized, single-blind, parallel controlled trial was conducted in 20 patients (20 eyes) with primary open-angle glaucoma complicated with cataract. Phacoemulsification cataract extraction combined with Ex-PRESS glaucoma drainage device implantation; 20 patients (20 eyes) in the control group were treated with phacoemulsification and trabeculectomy for 12 weeks. The indexes included intraocular pressure, visual acuity, filtering bleb, postoperative complications and so on. Results at 12 weeks after operation, IOP decreased from (28.7 卤6.9) mmHg (1 kPa=7.5 mmHg) to (11.3 卤2.5) mmHg, in the control group, from (29.1 卤7.1) mmHg to (12.0 卤2.5) mmHg, in the control group. IOP decreased significantly in both groups (P 0.01), but at 1 day, 1 week and 4 weeks after operation, IOP in the test group was lower than that in the control group (P 0.05). At 12 weeks after operation, the complete success rate of operation in the test group (95%) was significantly higher than that in the control group (70%), the difference was statistically significant (P0.05). In the control group, 3 eyes had low intraocular pressure (IOP), 3 eyes had anterior chamber hemorrhage, 2 eyes had non-functional filtering bleb, and 1 eye had malignant glaucoma. Conclusion Phacoemulsification cataract aspiration combined with Ex-PRESS glaucoma drainage is safe and effective in the treatment of primary open angle glaucoma with cataract.
【作者单位】：武汉市中心医院眼科;
【分类号】：R779.66

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