前房穿刺术联合两种不同手术方式治疗原发性急性闭角型青光眼合并白内障的临床效果

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Abstract Objective To observe the clinical effect of anterior chamber puncture combined with two different methods in the treatment of primary acute angle closure glaucoma with cataract. Methods A total of 68 patients with primary acute angle closure glaucoma with cataract in Dongguan Tungwah Hospital, Guangdong Province from June 2018 to June 2020 were selected as the research subjects. According to random number table method, they were divided into group A and group B, with 34 cases in each group. After anterior chamber puncture, group A was treated with phacoemulsification + intraocular lens implantation + goniosynechialysis, group B was treated with trabeculectomy. Visual acuity (converted from international standard visual acuity to LogMAR visual acuity), intraocular pressure, corneal endothelium count, retinal nerve fiber layer (RNFL) thickness, atrial angle open range and central anterior chamber depth (ACD) were recorded and compared between two groups before and three months after surgery. The incidence of complications in two groups was observed. Results Before surgery, there were no significant differences in visual acuity (LogMAR), ACD, atrial angle open range between two groups (P > 0.05). At three months after surgery, the visual acuity (LogMAR), ACD, atrial angle open range of group A were higher those that before surgery, and group A was higher than group B, and the differences were statistically significant (P < 0.05); while the visual acuity (LogMAR), ACD, atrial angle open range of group B were not significantly differences from those before surgery (P > 0.05). Before and three months after surgery, there was no significant difference in intraocular pressure between two groups (P > 0.05). Three months after surgery, intraocular pressure of two groups were lower than those before surgery, and the differences were statistically significant (P < 0.05). There were no significant differences in RNFL thickness between two groups before and three months after surgery (P > 0.05). Before surgery, there was no significant difference in corneal endothelium count between two groups (P ＞ 0.05). Three months after surgery, corneal endothelium count in group A was lower than that before surgery, and group A was lower than group B, and the differences were statistically significant (P < 0.05); while corneal endothelium count of group B was not significantly difference from that before surgery (P > 0.05). There was no significant difference in the incidence of complications between two groups (P > 0.05). Conclusion Anterior chamber puncture combined with two different methods can reduce intraocular pressure and protect visual function, but combined with phacoemulsification + intraocular lens implantation + goniosynechialysis can effectively increase anterior chamber depth and improve visual acuity, which is worthy of further clinical application.

Key words： Anterior chamber puncture Angle closure glaucoma Phacoemulsification Trabeculectomy

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	LI Chao DU Shaolin CHEN Hongjia MA Huihui

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LI Chao DU Shaolin CHEN Hongjia MA Huihui. Clinical effect of anterior chamber puncture combined with two different methods in the treatment of primary acute angle closure glaucoma with cataract[J]. 中国医药导报, 2021, 18(21): 105-109.

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https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2021/V18/I21/105

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