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目的 对比分析小梁切除联合白内障手术治疗原发性闭角型青光眼(PACG)合并初发期白内障的临床疗效和安全性.方法 随机选取2014年1月至2015年6月惠州市第一人民医院诊治的PACG患者150例(150眼),分为观察组(n=75)和对照组(n=75).观察组行小梁切除术联合白内障超声乳化术及人工晶体植入术,对照组行小梁切除术.术后随访观察眼压、视力、前房深度、术后并发症等指标,随访时间1年.分析PACG合并初发期白内障患者经小梁切除联合白内障超乳术后的临床疗效和安全性.结果 观察组与对照组术后各时间点比较,眼压均显著低于对照组,差异有统计学意义(P<0.05),观察组术后眼压控制效果明显好于对照组;术后1年复查观察组的术后视力、中央前房深度等指标均优于对照组,差异有统计学意义(P<0.05);观察组患者术前与术后比较,术后各指标也均优于术前,差异有统计学意义(P<0.05);术后1年观察组手术成功率明显高于对照组,差异有统计学意义(P<0.05);两组患者均未出现前房积血、脉络膜上腔出血、恶性青光眼、眼内炎等严重并发症,术后对照组的并发症例数明显多于观察组.结论 早期行小梁切除术联合白内障超声乳化吸除术治疗PACG合并初发期白内障能更好的降低眼压、提高视力,减少术后并发症的发生,是有效且安全的方法.“,”Objective To compare the clinical efficacy and safety of trabeculectomy combined with cataract surgery in the treatment of primary angle closure glaucoma(PACG)complicated with primary cataract. Methods 150 cases(150 eyes)of PACG patients treated from January 2014 to June 2015 were divided into two groups:75 cases in the observation group and 75 cases in the control group. Observation group was treated by trabeculectomy combined with cataract phacoemulsification and intraocular lens implantation , while the control group received trabeculectomy treatment alone. The intraocular pressure,visual acuity,anterior chamber depth,and postoperative complications were observed and followed up. Follow up time was 1 years. Clinical efficacy and safety of cataract phacoemulsification of the treatment were analyzed. Results The intraocular pressure at each time point after operation of the observation group was significantly lower than that of the control group(P<0.05). The postoperative IOP of the observation group was significantly better than that of the control group. After 1 years follow?up ,postoperative visual acuity ,anterior chamber depth and other indicators of the observation group were better than those of the control group;there were statistically significant differences(P<0.05). The postoperative indexes of the observation group patients were significantly better than those of preoperative indexes (P<0.05). After 1 year,the success rate of operation of the observation group was significantly higher than that of the control group (P<0.05). Two groups of patients did not appear hyphema ,suprachoroidal hemorrhage and malignant glaucoma and endophthalmitis and other serious complications;however,postoperative complications of the control group were significantly more than those of the observation group. Conclusion Early trabeculectomy combined with phacoemulsification in the treatment of primary angle closure glaucoma with primary cataract can better reduce intraocular pressure and improve visual acuity ,and reduce the incidence of postoperative complications ,which is a safe and effective method.