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目的:评价并比较一切口和二切口超声乳化白内障吸除术联合小梁切除术治疗慢性闭角型青光眼合并白内障的疗效。方法:采用前瞻性随机对照临床试验研究,包括41例41眼具有慢性闭角型青光眼合并白内障的患者。21例行一切口超声乳化白内障吸除术联合小梁切除术,20例行二切口手术。术后观察的指标包括:术后眼内压(IOP)、抗青光眼药物使用数量、最佳矫正视力(BCVA)以及术后并发症。所有研究对象随访9mo。结果:两组研究对象术前各项指标没有差别。术后9mo,一切口组和二切口组IOP分别从术前22.7±4.9mmHg,23.7±4.7mmHg降至18.0±1.2mmHg,16.7±1.1mmHg(P<0.05)。各随访时间点两组IOP差别没有统计学意义(P>0.05)。术后9mo,两组抗青光眼药物减少和BCVA提高差异均无统计学意义(P>0.05)。两种手术方式在术后并发症方面无差异。结论:两种超声乳化白内障吸除术联合小梁切除手术方式治疗的临床疗效和术后并发症没有明显差异。
OBJECTIVE: To evaluate and compare the efficacy of phacoemulsification and cataract surgery combined with trabeculectomy in the treatment of chronic angle-closure glaucoma complicated with cataract. METHODS: A prospective, randomized controlled clinical trial involving 41 patients with chronic angle-closure glaucoma and cataract who had 41 eyes. Twenty-one cases underwent phacoemulsification combined with trabeculectomy and 20 cases underwent two incisions. Postoperative indicators include intraocular pressure (IOP), anti-glaucoma drug use, best corrected visual acuity (BCVA), and postoperative complications. All subjects were followed up for 9 months. Results: There was no difference in preoperative indexes between the two groups. At 9 months after operation, the IOP of all the mouth and two incision groups decreased from 22.7 ± 4.9mmHg and 23.7 ± 4.7mmHg to 18.0 ± 1.2mmHg and 16.7 ± 1.1mmHg before operation (P <0.05). There was no significant difference in IOP between the two groups at each time point of follow-up (P> 0.05). At 9 months postoperatively, there was no significant difference between the two groups in anti-glaucoma medication and BCVA improvement (P> 0.05). There was no difference in the two surgical methods in postoperative complications. Conclusion: The clinical efficacy and postoperative complications of two phacoemulsification cataract surgery combined with trabeculectomy have no significant difference.