Wang Qing, Jiang Zheng-Xuan, Liao Rong-Feng
Department of Ophthalmology, the First Affiliated Hospital of Anhui Medical University, Hefei 230031, Anhui Province, China.
Department of Ophthalmology, the Fourth Affiliated Hospital of Anhui Medical University, Hefei 230012, Anhui Province, China.
Int J Ophthalmol. 2020 Feb 18;13(2):246-251. doi: 10.18240/ijo.2020.02.07. eCollection 2020.
To compare efficacy of coaxial microincisions (1.8 mm, 2.2 mm) and small incisions (3.0 mm) on phacoemulsification combined with trabeculectomy for primary angle-closure glaucoma (PACG) with cataract.
Ninety-six patients (96 eyes) with PACG and cataract were recruited and randomly divided into three groups between January 2015 and June 2017. Group A (3.0 mm incision), B (2.2 mm incision), and C (1.8 mm incision) comprised 30, 34 and 32 eyes respectively. All cases were treated with clear corneal incision phacoemulsification combined with trabeculectomy. Data including best corrected visual acuity (BCVA), corneal astigmatism, corneal endothelial cell counts (CECC), intraocular pressure (IOP), and complications were collected before the operation, and at postoperative 1d, 1 and 3mo.
All the patients were successfully treated with surgery. The BCVA of groups B and C were significantly improved as compared to group A at postoperative 1d, 1 and 3mo (all <0.05), but there was no difference between groups B and C at each time interval (all >0.05). The corneal astigmatism of group A was statistically higher than that of group B (=0.026); corneal astigmatism of group B was statistically higher than that of group C at postoperative 1d (=0.006). The corneal astigmatism of group A at postoperative 3mo was significantly higher than that before operation (=0.003). At postoperative 1 and 3mo, corneal astigmatism of groups B and C were significantly lower than that of group A (all <0.05). The CECC in group B was significantly higher than that of group A (=0.020), and CECC in group C was significantly higher than that of group B (=0.034) at postoperative 1d. At postoperative 1 and 3mo, CECC of groups B and C were significantly higher than that of group A (all <0.05). In each group, postoperative mean IOP at each time interval was significantly lower than preoperative IOP (all <0.05).
Coaxial microincision phacoemulsification combined with trabeculectomy for PACG with cataract has better curative efficacy in reducing postoperative corneal astigmatism and corneal endothelial cell injury than traditional small incision combined surgery, and the 1.8 mm microincision has better curative efficacy than 2.2 mm microincision in the early postoperative period.
比较同轴微小切口（1.8毫米、2.2毫米）与小切口（3.0毫米）在白内障合并原发性闭角型青光眼（PACG）的超声乳化吸除联合小梁切除术中的疗效。
选取2015年1月至2017年6月期间96例（96眼）PACG合并白内障患者，随机分为三组。A组（3.0毫米切口）、B组（2.2毫米切口）和C组（1.8毫米切口）分别有30眼、34眼和32眼。所有病例均行透明角膜切口超声乳化吸除联合小梁切除术。收集术前、术后1天、1个月和3个月的最佳矫正视力（BCVA）、角膜散光、角膜内皮细胞计数（CECC）、眼压（IOP）及并发症等数据。
所有患者手术均成功。术后1天、1个月和3个月时，B组和C组的BCVA较A组显著改善（均<0.05），但B组和C组在各时间点差异无统计学意义（均>0.05）。A组角膜散光高于B组（P=0.026）；术后1天时B组角膜散光高于C组（P=0.006）。A组术后3个月角膜散光显著高于术前（P=0.003）。术后1个月和3个月时，B组和C组角膜散光显著低于A组（均<0.05）。术后1天时B组CECC显著高于A组（P=0.020），C组CECC显著高于B组（P=0.034）。术后1个月和3个月时，B组和C组CECC显著高于A组（均<0.05）。每组术后各时间点平均眼压均显著低于术前眼压（均<0.05）。
白内障合并PACG的同轴微小切口超声乳化吸除联合小梁切除术在减少术后角膜散光和角膜内皮细胞损伤方面比传统小切口联合手术疗效更好，且1.8毫米微小切口在术后早期疗效优于2.2毫米微小切口。
