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目的研究白内障及白内障合并闭角型青光眼患者单纯行白内障超声乳化及后房型人工晶状体植入术对眼压及前房深度变化的影响。方法对单纯老年性白内障患者(白内障组)361例481眼、白内障合并闭角型青光眼患者(白内障合并青光眼组)44例52眼单纯行超声乳化及人工晶状体植入术,术后随访3~25个月。结果白内障组术前眼压(14.86±3.79)mmHg,术后最终随访眼压(12.56±3.43)mmHg,差异有统计学意义(t=9.270,P<0.01);白内障合并青光眼组术前眼压(19.92±3.76)mmHg,术后最终随访眼压(16.52±3.15)mmHg,差异有统计学意义(t=3.29,P<0.01)。两组间手术前眼压相比差异无统计学意义(t=-2.437,P>0.05),随访3个月以上两组间眼压相比差异无统计学意义(t=2.154,P>0.05)。白内障组手术前前房轴深(2.28±0.32)mm,术后最终复诊时前房轴深(3.04±0.39)mm,差异有统计学意义(t=7.781,P<0.01);白内障合并青光眼组手术前前房轴深(1.69±0.35)mm,术后最终复诊时前房轴深(2.82±0.41)mm,差异有统计学意义(t=4.528,P<0.01);两组间手术前前房轴深相比差异有统计学意义(t=8.325,P<0.01),手术后两组间相比差异无统计学意义(t=2.86,P>0.05)。结论对白内障患者行超声乳化及人工晶体植入术具有降低眼压的作用;白内障合并闭角型青光眼患者手术前用药将眼压控制在安全范围后而单纯行超声乳化及人工晶状体植入术,术后无需用降眼压药,眼压能控制在正常范围。
Objective To investigate the effects of phacoemulsification and posterior chamber intraocular lens implantation on intraocular pressure and depth of anterior chamber in patients with cataract and cataract combined with angle-closure glaucoma. Methods A total of 481 eyes of 361 patients with senile cataract (cataract group), 44 eyes (52 eyes) of cataract combined with angle-closure glaucoma (44 eyes) with phacoemulsification and intraocular lens implantation were followed up for 3 ~ 25 Months. Results The preoperative IOP was (14.86 ± 3.79) mmHg in the cataract group and the IOP was 12.56 ± 3.43 mmHg after the operation (t = 9.270, P <0.01). The preoperative intraocular pressure (19.92 ± 3.76) mmHg, the final follow-up intraocular pressure was (16.52 ± 3.15) mmHg, the difference was statistically significant (t = 3.29, P <0.01). There was no significant difference in IOP before operation between the two groups (t = -2.437, P> 0.05). There was no significant difference in IOP between the two groups at follow up of 3 months (t = 2.154, P> 0.05 ). The axial depth of the anterior chamber was (2.28 ± 0.32) mm in the cataract group and the depth of the anterior chamber was 3.04 ± 0.39 mm at the final follow-up (t = 7.781, P <0.01). There was no significant difference between the cataract group and the glaucoma group The axial depth of the anterior chamber was 1.69 ± 0.35 mm before surgery and 2.82 ± 0.41 mm at the final follow-up. The difference was statistically significant (t = 4.528, P <0.01) There was a significant difference in axial depth between the two groups (t = 8.325, P <0.01). There was no significant difference between the two groups after operation (t = 2.86, P> 0.05). Conclusion Cataract patients with phacoemulsification and intraocular lens implantation have the effect of reducing intraocular pressure; cataract patients with angle-closure glaucoma before surgery to control intraocular pressure in the safe range but simple phacoemulsification and intraocular lens implantation, No need to use ocular hypotensive drugs, intraocular pressure can be controlled in the normal range.