不同手术方法治疗闭角型青光眼合并短眼轴的对比观察

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1、不同手术方法治疗闭角型青光眼合并短眼轴的对比观察作者：周晓芳,付汛安,梅仲明,赵芳]【摘要】　　目的：比较单纯小梁切除术和小梁切除术联合白内障超声乳化联合人工晶状体植入术（以下简称三联术）治疗闭角型青光眼合并短眼轴的疗效。方法：回顾分析200507/200901收住我院的闭角型青光眼合并短眼轴患者31例39眼。行单纯小梁切除术者25眼，行三联术者14眼。术后随访1～25(平均9.51±6.11）mo。结果：术后眼压：三联术者术后眼压平均(11.31±0.69)mmHg，手术前后有显著统计学差异(P<0.01)；小梁切除术者术

2、后平均(18.47±3.54)mmHg，手术前后差异有统计学意义(P<0.05)；最佳矫正视力：三联术者术后均提高，≥0.3者占78%,小梁切除术者术后5眼视力不增反降，≥0.3者占32%，两者差异有显著性；UBM（超生生物显微镜）检查：小梁虹膜角(TIA)三联术者手术前后差异有显著性，小梁切除术者手术前后无显著性差异；中央前房深度(ACD)：三联术术后平均为(3.22±0.53)mm，手术前后有显著性差异(P<0.01)，小梁切除术后平均为(2.21±0.41)mm，比较差异无显著性；术后并发症：三联术术后并发症少，且均

3、无需再手术纠正，小梁切除术者术后并发症较多，部分严重且持久，需再次手术。结论：小梁切除术联合白内障超声乳化联合人工晶状体植入术治疗闭角型青光眼合并短眼轴较单纯小梁切除术设计更合理,手术成功率高,疗效好，并发症少。11【关键词】闭角型青光眼;短眼轴;超声乳化;三联术;小梁切除术　　AbstractAIM:Tocompareeffectofsimpletrabeculectomyandtrabeculectomycombinedwithcataractphacoemulsificationandintraocularlensimplan

4、tation(hereinafterreferredtoastriplesurgery)inthetreatmentofangleclosureglaucomawithshortaxiallength.METHODS:Thirtynineeyesfrom31patientswhosufferedfromangleclosureglaucomawithshortaxiallengthfromJuly2005toJanuary2009wereretrospectivelyanalyzed，inwhich25eyeshadunderg

5、onesimpletrabeculectomy,14triplesurgeon.Thepatientswerefollowedupfor125monthswithanaverageof（9.51±6.11）monthsRESULTS:Postoperativeintraocularpressure(IOP):theaverageIOPaftertriplesurgerywas(11.31±0.69)mmHg,beforeandaftersurgerytherewasastatisticallysignificantdifferen

6、ce(P<0.01),theaverageIOPaftertrabeculectomywas(18.47±3.54)mmHg,beforeandaftersurgerythedifferencewasstatisticallysignificant(P<0.05);Bestcorrectedvisualacuity(BCVA):allBCVAwereincreasedaftertriplesurgery,ofwhich78%≥0.3,BCVAof5eyesdroppedinsteadofrisingaftertrabec

7、ulectomy,ofwhich32%≥0.3,thetwomethods11hadasignificantdifference;ultrasoundbiomicroscope(UBM):beforeandaftertriplesurgerytherewasastatisticallysignificantdifferenceintrabecubririsangle(TIA),butnodifferencebeforeandaftersimpletrabeculectomy;anteriorchamberdepth(ACD):thea

8、verageACDaftertriplesurgerywas(3.22±0.53)mm,beforeandaftersurgerytherewasastatisticallysignificantdifference(P