超声乳化联合青光眼手术治疗原发性开角型青光眼的屈光效果观察

Dina Adam, Madeeha Kamel, Doaa A. Mahmoud
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引用次数: 0

摘要

青光眼和白内障是全球致盲的主要原因。对任何一种疾病的治疗都会影响另一种疾病的病程。小梁切除术引起前房深度、眼轴长度(AL)和角膜曲率的改变,影响联合手术中人工晶状体度数计算的准确性。目的评价合并白内障和青光眼联合手术与单纯白内障手术(超声乳化术)后人工晶状体计算和屈光结果的准确性。患者和方法本研究是一项前瞻性非随机对照研究,对连续43例(60只眼)白内障合并青光眼患者进行了白内障小梁切除术(第1组)或仅行白内障乳化手术(第2组)。每个病例的生物计量预测误差是通过术后实际屈光度与术前预测屈光度的差值来确定的,然后对平均绝对屈光度进行比较分析。最佳矫正视力、术后1 ~ 3个月眼内压(IOP)。结果两组患者最佳矫正视力均有改善,IOP均有明显下降。两组术后1、3个月的平均绝对屈光不全差异无统计学意义(P>0.05), 1组因高泡、结膜或巩膜缝合线及前房深度的改变而出现较多的圆柱形变化和近视偏移。结论青光眼超声乳化术治疗青光眼的远期疗效稳定,预测误差与超声乳化术相似。然而,它在降低眼压方面更有效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Refractive outcome of combined phacoemulsification and glaucoma surgery in patients of primary "open-angle glaucoma"
Introduction Glaucoma and cataracts are the leading causes of blindness worldwide. Treatment of either condition can influence the course of the other. Trabeculectomy induces changes to anterior chamber depth, axial length (AL), and corneal curvature, which could influence the accuracy of intraocular lens power calculations in combined surgery. Aim Assessment accuracy of intraocular lens calculation and refractive outcome after combined surgery versus cataract surgery (phacoemulsification) alone for coexisting cataract and glaucoma. Patients and methods Our study is a prospective nonrandomized comparative study of 43 consecutive patients (60 eyes) with cataract with coexisting glaucoma who had undergone phacotrabeculectomy (group 1) or phacoemulsification only (group 2). The biometry prediction error was determined for each case by the difference between the actual postoperative refraction and the preoperative predicted refraction in a spherical equivalent followed by comparative analysis of mean absolute refractive error, best-corrected visual acuity, and intraocular pressure (IOP) before and after surgery at 1, 3 months postoperatively. Results In both groups, best-corrected visual acuity was improved and IOP was decreased significantly. Mean absolute refractive error at 1, 3 months postoperatively was not significantly different between two groups (P>0.05) with more cylindrical changes and myopic shifts in group 1 due to high bleb, conjunctival or scleral suture, and changes in anterior chamber depth. Conclusion Phacotrabeculectomy may be an effective treatment with stable long-term outcomes of prediction error similar to phacoemulsification in patients with glaucoma. However, it is more effective in lowering IOP.
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