Anand N, Menage M J, Bailey C
Department of Ophthalmology, Leeds General Infirmary, England.
Acta Ophthalmol Scand. 1997 Dec;75(6):705-10. doi: 10.1111/j.1600-0420.1997.tb00635.x.
To compare three methods of combined cataract extraction and glaucoma surgery.
Retrospective review of 35 eyes of patients who had extracapsular cataract extraction and trabeculectomy using a corneoscleral incision (SAME), 54 eyes undergoing extracapsular cataract extraction and trabeculectomy using a separated corneal incision for cataract extraction and 43 eyes undergoing phacoemulsification and trabeculectomy.
Ninety-one percent of the eyes in the SAME group, 85% of the SEPARATE group and 97% of the phacoemulsification and trabeculectomy group had an IOP < 22 mmHg at 6 months with or without medication (NS). Postoperative visual acuity and astigmatism were not significantly different between the groups. The number of eyes requiring YAG laser capsulotomy was significantly greater in the extracapsular cataract extraction and trabeculectomy (same and separated incision) as compared to the phacoemulsification and trabeculectomy group (P < 0.001).
Phacoemulsification and trabeculectomy was not significantly more successful than the other methods of combined surgery. Although complication rates were similar, visual rehabilitation was faster and there was a reduced incidence of early posterior capsule opacification.
比较三种白内障摘除联合青光眼手术的方法。
回顾性分析35例采用角巩膜切口行白内障囊外摘除联合小梁切除术(SAME组)、54例采用单独角膜切口行白内障摘除联合小梁切除术以及43例行超声乳化联合小梁切除术患者的35只眼、54只眼和43只眼。
SAME组91%的患眼、SEPARATE组85%的患眼以及超声乳化联合小梁切除术组97%的患眼在术后6个月无论是否使用药物眼压均<22 mmHg(无统计学差异)。各组间术后视力和散光无显著差异。与超声乳化联合小梁切除术组相比,白内障囊外摘除联合小梁切除术(相同和单独切口)组需要YAG激光晶状体后囊切开术的患眼数量显著更多(P<0.001)。
超声乳化联合小梁切除术并不比其他联合手术方法显著更成功。虽然并发症发生率相似,但视觉康复更快,早期后囊膜混浊的发生率降低。