颞上象限角膜缘遂道微切口超声乳化联合人工晶状体植入术治疗青光眼小梁切除术后白内障病人的短期随访研究

孙文娟; 李永蓉

doi:10.13898/j.cnki.issn.1000-2200.2020.04.015

颞上象限角膜缘遂道微切口超声乳化联合人工晶状体植入术治疗青光眼小梁切除术后白内障病人的短期随访研究

Study on the short-term following-up of the superior temporal quadrant limbal tunnel microincision phacoemulsification combined with intraocular lens implantation for cataract patients after glaucoma trabeculectomy

摘要

摘要:
目的探讨颞上象限角膜遂道微切口超声乳化联合人工晶状体植入术治疗青光眼小梁切除术后白内障的效果及安全性。
方法选取青光眼小梁切除术后白内障病人102例，随机数字表法分为对照组和观察组，各51例。观察组采取颞上象限角膜遂道微切口超声乳化联合人工晶状体植入术，对照组采取常规超声乳化联合人工晶状体植入术。术后随访1~6个月，统计2组角膜散光度、最佳矫正视力、前房深度、眼压水平、并发症（脉络膜脱离、滤过泡漏、一过性眼压增高、角膜水肿）发生率。
结果术后1周2组角膜散光度较术前增高，且观察组低于对照组（P < 0.01）；术后1个月、3个月、6个月两组角膜散光度较术后1周降低，且观察组术后1个月、3个月低于对照组（P < 0.01）；术后1个月、3个月、6个月两组最佳矫正视力较术前提高、前房深度较术前增高、眼压水平较术前降低，且观察组最佳矫正视力高于对照组、前房深度大于对照组、眼压低于对照组（P < 0.05~P<0.01）；观察组并发症发生率（7.84%）低于对照组（23.53%）（P < 0.05）。
结论联合采取颞上象限角膜遂道微切口超声乳化及人工晶状体植入术治疗青光眼小梁切除术后白内障病人，可有效增大前房深度，降低眼压，提高病人最佳矫正视力，且手术源性散光程度较轻微，术后并发症发生率较低，具有安全性。

Abstract:
ObjectiveTo explore the effects and safety of superior temporal quadrant limbal tunnel microincision phacoemulsification combined with intraocular lens implantation for cataract patients after glaucoma trabeculectomy.
MethodsOne hundred and twenty cataract patients treated with glaucoma trabeculectomy were randomly divided into the control group (n=51) and obnservation group (n=51).The observation group and control group were treated with superior temporal quadrant limbal tunnel microincision phacoemulsification combined with intraocular lens implantation and conventional phacoemulsification combined with intraocular lens implantation, respectively.Two groups were followed up for 1 to 6 months after operation, and the degree of corneal astigmatism, best corrected visual acuity, anterior chamber depth, intraocular pressure level and incidence of complications (choroidal detachment, filtering bleb leak, transient increase in intraocular pressure and corneal edema) were analyzed in two groups.
ResultsAfter 1 week, the degree of corneal astigmatism in two groups increased compared before operation, and which in observation group was lower than that in control group (P < 0.01).Compared after 1 week of operation, the degree of corneal astigmatism in two groups decreased after 1 month, 3 months and 6 months of operation, and which in observation group after 1 and 3 months was lower than that in control group (P < 0.01).After 1, 3 and 6 months of operation, the best corrected visual acuity, anterior chamber depth and intraocular pressure level in two groups improved, increased and decreased compared before operation, respectively, and the best corrected visual acuity, anterior chamber depth and intraocular pressure level in obseravtion group were higher, greater and lower than whose in control group, respectively (P < 0.05 to P<0.01).The incidence rate of complications in observation group (7.84%) was lower than that in control group (23.53%)(P < 0.05).
ConclusionsThe superior temporal quadrant limbal tunnel microincision phacoemulsification combined with intraocular lens implantation for cataract patients after glaucoma trabeculectomy can effectively increase the anterior chamber depth, reduce intraocular pressure and improve the best corrected visual acuity of the patients.The degree of surgically induced astigmatism is mild, and the incidence of postoperative complications is low, which is safe.

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