|
|
|
| Effect of phacoemulsification and trabeculectomy in the treatment of angle-closure glaucoma and cataract and the changes of postoperative visual acuity and angular structure |
| LI Ting, HU Hongmei, LIU Hanjun, YE fan |
| Department of Ophthalmology, Xiantao First People's Hospital Affiliated to Yangtze University, Xiantao 429004, China |
|
|
|
|
Abstract Objective To evaluate the overall efficacy of phacoemulsification combined with trabeculectomy in the treatment of angle-closure glaucoma and cataract using postoperative visual acuity level and changes of Angle structure as evaluation indexes. Methods In this study, 82 patients with angle-closure glaucoma and cataract admitted to the ophthalmology department of the First People's Hospital of Xiantao City from January 2020 to November 2022 were selected as research objects, and divided into control group (n=39) and combination group (n=43) according to different surgical methods. Patients with angle-closure glaucoma and cataract in the control group were treated with trabeculectomy alone, and patients with angle-closure glaucoma and cataract in the combined group were treated with phacoemulsification combined with trabeculectomy. The evaluation indexes included the changes of visual acuity, intraocular pressure and angular structural parameters before and after surgery, visual quality one month after surgery, and perioperative complications. Results One month after surgery, the visual acuity of both groups was significantly increased, and the intraocular pressure of patients was significantly decreased, and compared with the control group, the combined group had significantly higher visual acuity and significantly lower intraocular pressure. The central anterior chamber depth of the two groups one month after operation, trabecular iris Angle, opening distance of room Angle were higher than before surgery, and the combination group was significantly higher than control group. Before and after operation, the distance of trabecular ciliary process was measured and compared between the two groups, the results showed no statistical significance. According to the postoperative 1 month watching TV, reading, night vision and fine manipulation, the combined group had higher scores than the control group. The total complication rate was 41.03% in the control group and 16.28% in the combination group, which was significantly lower than that in the control group. Conclusion For the treatment of angle-closure glaucoma and cataract, phacoemulsification combined with trabeculectomy has many advantages. Compared with conventional trabeculectomy, phacoemulsification combined with trabeculectomy can more effectively promote the recovery of visual function, improve the parameters of room Angle structure, and reduce the incidence of perioperative complications.
|
|
Received: 30 November 2022
|
|
|
|
|
|
[1] Yao L, Yang X, Jia S, et al.Combined Surgery Versus Phacoemulsification Alone for Patients with Primary Angle-Closure Glaucoma: A meta-analysis[J]. Semin Ophthalmol, 2022, 1-8.
[2] Wang Q, Jiang ZX, Liao RF, et al.Outcomes of 1.8-3.0 mm incision phacoemulsification combined with trabeculectomy for primary angle-closure glaucoma with cataract[J]. Int J Ophthalmol, 2020, 13(2): 246-251.
[3] Song BJ, Ramanathan M, Morales E, et al.Trabeculectomy and Combined Phacoemulsification-Trabeculectomy: Outcomes and Risk Factors for Failure in Primary Angle Closure Glaucoma[J]. J Glaucoma, 2016, 25(9): 763-769.
[4] Ong AY, Ng SM, Vedula SS, et al. Lens extraction for chronic angle-closure glaucoma[J]. Cochrane Database Syst Rev.2021 Mar 24; 3(3): CD005555.
[5] 曹晋, 胡新苗, 马宝宝. 超声乳化白内障吸除与房角分离术治疗闭角型青光眼合并白内障患者的疗效及其对房角宽度的影响分析[J]. 黑龙江医学, 2022, 46(23): 2848-2850.
[6] 李本聪, 汪丽娟, 周丽, 等. 白内障超声乳化、人工晶体植入、房角分离联合虹膜根切术治疗原发性闭角型青光眼合并白内障的疗效观察[J]. 中国实用医药, 2022, 17(25): 1-5.
[7] 付馨余. 不同手术治疗方式对闭角型青光眼合并白内障患者术后临床效果及安全性的研究[J]. 四川医学, 2022, 43(11): 1129-1133.
[8] 中华医学会眼科学分会青光眼学组. 中国原发性闭角型青光眼诊治方案专家共识(2019)年[J]. 中华眼科杂志, 2019, 55(5): 325-328.
[9] 杨梅. 原发性闭角型青光眼合并白内障应用晶状体超声乳化+人工晶体植入联合小梁切除术治疗效果探析[J]. 吉林医学, 2022, 43(11): 2974-2976.
[10] 苏安乐, 赵帅, 王昞. PHACO+IOL分别联合小梁切除术、房角分离术治疗急性原发性闭角型青光眼合并年龄相关性白内障的效果比较[J]. 海南医学, 2022, 33(21): 2788-2791.
[11] Song Y, Zhang Y, Li F, et al.One-Year Results of a Multicenter Study: Intraocular Pressure-Lowering Effect of Combined Phacoemulsification, Goniosynechialysis, and Goniotomy for Cases of Advanced Primary Angle-Closure Glaucoma With Cataract[J]. Asia Pac J Ophthalmol (Phila), 2022, 11(6): 529-535.
[12] 王慧琴, 余晓峰, 应充慧. PEI+GSL+TM术治疗慢性闭角型青光眼合并白内障疗效分析[J]. 全科医学临床与教育, 2022, 20(10): 941-943.
[13] 刘涵, 李新星. 晶状体诱导性青光眼的诊治进展[J]. 眼科学报, 2022, 37(10): 827-834.
[14] 杨涛, 项振扬, 陈爱菊, 等. 三联术治疗高龄闭角型青光眼合并白内障的临床疗效观察[J]. 浙江创伤外科, 2022, 27(5): 821-823.
[15] 刘国颖, 邓嘉进, 赵柳宁. 系统评价激光周边虹膜成形术治疗急性闭角型青光眼的疗效[J]. 吉林医学, 2022, 43(9): 2336-2342.
[16] 李兰, 李志国, 谢洪. 白内障合并闭角型青光眼超声乳化术后疗效观察[J]. 浙江创伤外科, 2022, 27(04): 649-651.
[17] 马恒哲. 三联手术治疗老年白内障合并急性闭角型青光眼的近期效果分析[J]. 检验医学与临床, 2022, 19(12): 1699-1702.
[18] 钟珊, 李桂荣, 杨卉. 超声乳化晶体摘除联合房角分离术治疗急性闭角型青光眼合并白内障的临床研究[J]. 微创医学, 2022, 17(3): 282-285+322.
[19] 雷蕊莲, 赵军梅. 青光眼-白内障联合术后患者屈光误差及其与术前眼球生物学参数的相关性[J]. 眼科新进展, 2022, 42(6): 480-484. |
|
|
|
2023, Vol. 20 
