超声乳化白内障吸除术对合并白内障的原发性房角关闭及原发性闭角型青光眼的影响

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1、安徽医科大学硕士学位论文目录中文摘要··············································2英文摘要··············································4引言··················································6材料与方法············································9结果··················································11讨论·············

2、·····································16结论··················································20参考文献··············································20论文附图··············································24附录··················································26致谢···································

3、···············27综述及参考文献········································28安徽医科大学硕士学位论文摘要超声乳化白内障吸除术对合并白内障的原发性房角关闭及原发性闭角型青光眼的影响青光眼和白内障都是中老年人常见的眼科疾病，临床上合并白内障的青光眼病人并不少见，常见的手术策略有三种：1.单纯白内障手术2.青光眼白内障联合手术3.先行青光眼手术，二期行白内障手术。由于单纯白内障手术具有疗效好，并发症少，一种手术同时解决两种疾病等优点。近年来，大量研究报道了单纯白内障手术在各种类型青光眼患者中的疗效。原发性房角关闭（PAC

4、）和原发性闭角型青光眼（PACG）的定义来自于Foster2002年在闭角型青光眼的患病率调查中提出了一种新的分类系统----ISGEO(国际地域性和眼科流行病学组)分类系统,这种分类系统在国外已得到普遍的认可，但在国内还存在争议。目的：评价超声乳化白内障吸除联合人工晶状体植入术（Phaco+IOL）对合并白内障的原发性房角关闭（PAC）及原发性闭角型青光眼（PACG）的手术效果。方法：根据Foster（2002）在闭角型青光眼的患病率调查中提出了一种新的分类系统——ISGEO(国际地域性和眼科流行病学组)分类诊断标准，选择收住我院眼科的合并白内障的PAC患者24例24

5、眼和PACG患者27例27眼，药物控制眼压至21mmHg以下后，施行白内障超声乳化吸除联合人工晶状体植入术，随访至6个月，观察最佳矫正视力、眼压、周边房角粘连关闭范围等指标。结果：术后6个月视力较之术前差异有统计学意义（Z=5.025，P＜0.001）。两组病人术后各随访时间段眼压对比术前用药下眼压差异均有统计学意义。PAC组术前和术后6个月的平均眼压为（14.04±1.01）mmHg及（11.98±1.33）mmHg（t=8.907，P=0.000），PACG组术前和术后六个月的平均眼压为（17.11±1.23）mmHg及（15.08±2.96）mmHg（t=3.69

6、8，P=0.001）。眼压下降幅度在两组间无统计学意义（术后6个月，t=0.018,P=0.986）。两组术后房角周边粘连均有不同程度的减轻，差异有统计学意义。(PAC组Z=6.120，P＜0.001，PACG组Z=2.345，P=0.019，)。1安徽医科大学硕士学位论文结论：超声乳化白内障吸除联合人工晶状体植入术能显著提高经药物控制的PAC和PACG合并白内障病人的视力，降低眼压，开放房角，短期内避免PAC的再次发作，眼压下降幅度在两组间差异无统计学意义。关键词：原发性房角关闭；白内障超声乳化吸除术；周边房角粘连关闭；白内障2安徽医科大学硕士学位论文Abstract

7、Theefficacyofphacoemulsificationineyeswithprimaryangleclosureorprimaryangle-closureglaucomawhichiscombinedwithcataractGlaucomaandcataractarecommoninseniorcitizens.Therearethreestrategies,totacklewiththeglaucomapatientscombinedwithcataract:1.extracapsularcataractextraction