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药物控制的非重度慢性原发性闭角型青光眼合并白内障与超声乳化白内障吸除联合小梁切除术手术治疗的对比临床研究

Comparative Clinical Study of Medically Controlled Nonsevere Chronic Primary Angle-closure Glaucoma with Coexisting Cataract Surgically Managed by Phacoemulsification as against Combined Phacotrabeculectomy.

作者信息

Chelerkar Vidya, Parekh Puja, Kalyani V K S, Deshpande Madan, Khandekar Rajiv

机构信息

Department of Glaucoma, PBMA's H. V. Desai Eye Hospital, Hadapsar, Pune, Maharashtra, India.

Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.

出版信息

Middle East Afr J Ophthalmol. 2018 Jul-Dec;25(3-4):119-125. doi: 10.4103/meajo.MEAJO_204_17.

Abstract

PURPOSE

Comparative clinical study of medically controlled non-severe chronic Primary Angle Closure Glaucoma (PACG) with co-existing cataract surgically managed by phacoemulsification as against combined phacotrabeculectomy.

METHODS

This randomized clinical trial was conducted between December 2011 and December 2013. Patients were randomly assigned to Phacoemulsification (PE) and Phacotrabeculectomy (PT) groups for surgery. Intraocular pressure, anti-glaucoma medications, Best Corrected Visual Acuity, anterior chamber angle widening and post-operative complications in both groups were compared after 12 months.

RESULTS

There were 46 eyes with PACG in PE group and 45 in PT group. The IOP at 12 months in PE group was 11.5±1.3mmHg and 11.8±1.2mmHg in PT gr. (p = 0.28). The eyes requiring single anti-glaucoma medications at 12months in PE group was 0, PT group was 1 (p = 0. 495). The post op BCVA at 12months in PE group 0.3+-0.12 and 0.33±0.15 in PT group (p = 0.22). 3 cases in PT group required additional intervention whereas no additional intervention was required in PE group and this difference was statistically significant (p = 0.116).

CONCLUSION

Phacoemulsification is equally effective in terms of intraocular pressure control and visual outcome as phacotrabeculectomy with better safety and less post-operative complication.

摘要

目的

比较药物控制的非重度慢性原发性闭角型青光眼(PACG)合并白内障患者,经超声乳化手术与联合超声乳化小梁切除术治疗的临床效果。

方法

本随机临床试验于2011年12月至2013年12月进行。患者被随机分配至超声乳化(PE)组和超声乳化小梁切除术(PT)组进行手术。比较两组术后12个月时的眼压、抗青光眼药物使用情况、最佳矫正视力、前房角增宽及术后并发症。

结果

PE组有46只PACG眼,PT组有45只。PE组12个月时眼压为11.5±1.3mmHg,PT组为11.8±1.2mmHg(p = 0.28)。PE组12个月时需要单一抗青光眼药物治疗的眼数为0,PT组为1只(p = 0.495)。PE组12个月时术后最佳矫正视力为0.3±0.12,PT组为0.33±0.15(p = 0.22)。PT组有3例需要额外干预,而PE组无需额外干预,且差异具有统计学意义(p = 0.116)。

结论

在眼压控制和视力预后方面,超声乳化术与超声乳化小梁切除术同样有效,且安全性更高,术后并发症更少。

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