超声乳化联合不同术式对青光眼合并白内障患者视力、血流动力学及生活质量的影响

目的:探讨超声乳化联合不同术式对青光眼合并白内障患者视力、血流动力学及生活质量的影响。方法:回顾性分析2015年1月～2019年8月期间我院收治的青光眼合并白内障患者56例(66眼)的临床资料,根据手术方式的不同分为A组(n=27,超声乳化联合小梁切除术)和B组(n=29,超声乳化联合房角分离手术),比较两组患者视力、眼压、血流动力学及生活质量情况,统计两组并发症发生情况。结果:两组术后1个月、术后3个月、术后6个月视功能指数量表(VF-14)评分呈升高趋势,且B组高于A组(P0.05)。两组患者术后1个月、3个月、6个月视力呈先升高后降低,且术后1个月、3个月、6个月均高于术前(P0.05),B组术后3个月、术后6个月视力均高于A组(P0.05);两组患者术后1个月～术后6个月眼压均呈不断下降趋势,且B组低于A组(P0.05)。两组术后6个月舒张末期流速(EDV)、收缩期峰值流速(PSV)均升高,且B组高于A组(P0.05);阻力指数(RI)均降低,且B组低于A组(P0.05)。两组并发症发生率比较差异无统计学意义(P0.05)。结论:与超声乳化联合小梁切除术相比,超声乳化联合房角分离手术治疗青光眼合并白内障患者,在改善患者视力、眼压、血流动力学及生活质量方面效果较佳,且不增加并发症发生率。

The Effect of Phacoemulsification Combined with Different Operation Methods on Vision, Hemodynamics and Quality of Life of Glaucoma Patients with Cataract

ABSTRACT Objective: To investigate the effect of phacoemulsification combined with different surgical methods on vision, hemodynamics and quality of life in patients with glaucoma and cataract. Methods: The clinical data of 56 patients (66 eyes) with glaucoma and cataract who were admitted to our hospital from January 2015 to August 2019 were analyzed retrospectively. According to the different operation methods, they were divided into two groups: group A(n=27, phacoemulsification combined with trabeculectomy) and group B (n=29, phacoemulsification combined with angle separation). The visual acuity, intraocular pressure, hemodynamics and quality of life of the two groups were compared. The complications of the two groups were counted. Results: The visual function index (VF-14) of the two groups increased in 1 month after operation, 3 months after operation and 6 months after operation, and group B was higher than group A(P<0.05). The visual acuity of the two groups increased first and then decreased at 1, 3 and 6 months after operation, and it was higher at 1, 3 and 6 months after operation than that before operation(P<0.05). The visual acuity of group B was higher at 3 and 6 months after operation than that of group a(P<0.05). The intraocular pressure of the two groups decreased continuously from 1 month to 6 months after operation, and group B was lower than that of group A (P<0.05). The end diastolic velocity (EDV) and peak systolic velocity (PSV) in group B were higher than that in group A(P<0.05), and the resistance index (RI) was lower in group B than that in group A (P<0.05). There was no significant difference in the incidence of complications between the two groups (P<0.05). Conclusion: Compared with phacoemulsification combined with trabeculectomy, phacoemulsification combined with angle separation is better in improving vision, intraocular pressure, hemodynamics and quality of life of patients with glaucoma combined with cataract, and does not increase the incidence of complications.