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目的通过对复合式小梁切除术、超声乳化白内障吸除术与可折叠式人工晶状体植入术分期手术治疗的回顾性分析,探讨青光眼合并白内障的手术方式选择。方法收集2000年至2002年期间行复合式小梁切除术,而后再行超声乳化白内障吸除术与可折叠式人工晶状体植入术54例58只眼,对2种手术前后的白内障、视力及眼压进行比较,并对2种手术间隔时间的相关因素进行分析。结果复合式小梁切除术后晶状体混浊程度加重、视力下降,经超声乳化白内障吸除术与可折叠式人工晶体植入术后视力基本回复。短期内白内障手术未影响小梁切除术后的眼压。抗青光眼手术与白内障手术间的间隔时间与患者年龄及青光眼术前眼压无相关性(P>0.05)。原发性闭角型青光眼的手术间隔时间短于原发性开角型青光眼,差异有统计学意义(P<0.05)。结论对于原发性闭角型青光眼,在选择手术治疗方式时须考虑白内障的影响。对于低视力患者,当需要进行滤过性手术时,复合式小梁切除术与超声乳化白内障吸除术的联合治疗可能优于分期手术治疗。
Objective To retrospectively analyze the surgical treatment of compound trabeculectomy, phacoemulsification and foldable intraocular lens implantation in order to discuss the selection of surgical methods for glaucoma combined with cataract. Methods A total of 54 eyes (54 eyes) with phacoemulsification and foldable intraocular lens implantation underwent phacoemulsification combined with trabeculectomy between 2000 and 2002. The changes of cataract, Intraocular pressure were compared, and the two factors related to the operation interval analysis. Results After compound trabeculectomy, the opacity of the lens was aggravated and the visual acuity was decreased. The visual acuity returned after phacoemulsification and foldable intraocular lens implantation. Short-term cataract surgery did not affect intraocular pressure after trabeculectomy. There was no correlation between glaucoma surgery and cataract surgery time and patient’s age and glaucoma preoperative intraocular pressure (P> 0.05). The primary angle-closure glaucoma surgery shorter than primary open-angle glaucoma, the difference was statistically significant (P <0.05). Conclusions For primary angle-closure glaucoma, the effect of cataract must be considered when selecting the surgical approach. For patients with low vision, combination trabeculectomy and phacoemulsification may be superior to staging surgery when filtering surgery is required.