广西医学

目的探讨房角分离术联合白内障超声乳化术治疗原发性闭角型青光眼（PACG）合并白内障患者的临床效果。方法将64例PACG合并白内障患者随机分为对照组和观察组，每组32例。对照组采用小梁切除术联合白内障超声乳化术进行治疗，观察组采用房角分离术联合白内障超声乳化术进行治疗。比较两组患者术前及术后3个月的最小分辨角对数（logMAR）视力、眼压、中央前房深度、房角状态、角膜内皮细胞密度、角膜中心厚度、角膜内皮细胞平均面积，以及术后3个月的并发症发生情况。结果术后3个月，两组患者的logMAR视力、眼压、角膜内皮细胞密度、角膜中心厚度、角膜内皮细胞平均面积较术前降低，中央前房深度较术前升高（P＜0.05）；观察组患者的logMAR视力、眼压、中央前房深度、角膜内皮细胞密度高于对照组，房角状态优于对照组，角膜中心厚度、角膜内皮细胞平均面积、并发症总发生率低于对照组（P＜0.05）。结论采用房角分离术联合白内障超声乳化术治疗PACG合并白内障有助于降低患者眼压，提高视力，改善房角状态，且对角膜内皮的损伤较小，并发症发生率较低。

ObjectiveTo explore the clinical effect of goniosynechialysis combined with cataract phacoemulsification for the treatment of primary angle-closure glaucoma (PACG) and concomitant cataract. MethodsA total of 64 patients with PACG and concomitant cataract were randomly divided into control group or observation group, with 32 cases in each group. The control group received trabeculectomy combined with cataract phacoemulsification for treatment, while the observation group received goniosynechialysis combined with cataract phacoemulsification for treatment. The logarithm of minimum resolution angle (logMAR) visual acuity, intraocular pressure, central anterior chamber depth, chamber angle status, corneal endothelial cell density, central corneal thickness, and average area of corneal endothelial cells before operation and 3 months after operation, as well as occurrence of complications 3 months after operation were compared between patients of the two groups. ResultsAfter 3 months of operation, patients of both groups obtained decreased logMAR visual acuity, intraocular pressure, corneal endothelial cell density, central corneal thickness, and average area of corneal endothelial cells, whereas elevated central anterior chamber depth as compared with before operation (P＜0.05); furthermore, the observation group exhibited higher logMAR visual acuity, intraocular pressure, central anterior chamber depth, and corneal endothelial cell density as compared with the control group, and superior chamber angle status, as well as a thin central corneal thickness, a smaller average area of corneal endothelial cells, and a lower total incidence rate of complications as compared with the control group (P＜0.05). ConclusionEmploying goniosynechialysis combined with cataract phacoemulsification for the treatment of patients with PACG and concomitant cataract is beneficial for decreasing intraocular pressure, improving visual acuity, ameliorating chamber angle status in patients, exerting a smaller damage on corneal endothelium, and a lower incidence rate of complications.