Clinical effect and prognostic factors of micro-incision phacoemulsification and aspheric intraocular lens in 89 cases of primary angle-closure glaucoma
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摘要: 目的 选择宁波市奉化区中医医院2014年9月—2016年7月收治的89例95眼患者,随机分为观察组(45例,49眼)和对照组(44例,46眼)。观察组患者给予微切口白内障超声乳化术联合非球面人工晶体植入术,对照组患者给予复合式小梁切除术。观察比较2组治疗前后的最佳矫正视力、眼压、前房深度水平及术后并发症发生情况,分析治疗结局的相关影响因素。 结果 治疗后,2组最佳矫正视力及前房深度均显著升高,眼压降低(P<0.05),且观察组最佳矫正视力及前房深度均显著高于对照组,眼压显著低于对照组(t=5.391,P<0.001;t=-5.484,P<0.001;t=2.048,P=0.043)。观察组术后并发症发生率为26.53%,低于对照组的32.61%,组间差异未见统计学意义(χ2=0.422,P=0.516)。与治疗结局相关的因素有:年龄、晶状体厚度及房角粘连(P<0.05)。 结论 微切口白内障超声乳化术与非球面人工晶体治疗原发性闭角型青光眼临床效果显著,可有效改善视力,加深前房深度,降低眼压,安全性高。年龄、晶状体厚度及房角粘连影响治疗效果。Abstract: Objective To explore the clinical effect and prognostic factors of micro-incision phacoemulsification and aspheric intraocular lens on primary angle-closure glaucoma. Methods Ninety-five eyes of 89 cases admitted to our hospital from September,2014 to July,2016 were randomly divided into observation group(n=45,49 eyes) and control group(n=44,46 eyes).The observation group received micro-incision phacoemulsification combined with aspheric intraocular lens,while the control group received compound trabeculectomy.The best corrected visual acuity,intraocular pressure,anterior chamber depth and postoperative complications in the two groups were compared before and after the treatment,and the related factors affecting the treatment outcome were analyzed. Results After the treatment,the best corrected visual acuity and anterior chamber depth were significantly increased and the intraocular pressure decreased in both groups(P<0.05).The best corrected visual acuity and anterior chamber depth in the observation group were significantly higher than those in the control group,and intraocular pressure was significantly lower than that in the control group(t=5.391,P<0.001;t=-5.484,P<0.001;t=2.048,P=0.043).The incidence of postoperative complications in the observation group was 26.53%,which was lower than 32.61% in the control group,but there was no statistical difference between the two groups(χ2=0.422,P=0.516).The age,lens thickness and angle of attachment were the factors which associated with treatment outcome. Conclusion Micro-incision phacoemulsification combined with aspheric intraocular lens has a significant clinical efficacy in the treatment of primary angle-closure glaucoma,which can effectively improve the vision,deepen the anterior chamber depth,reduce intraocular pressure,with high safety.The age,lens thickness and angle of attachment are closely related to the treatment outcome.
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