ABSTRACT
·AIM: To study clinical efficacy of phacoemulsification combined with goniosynechialysis in treating primary angle-closure glaucoma with age-related cataract. ·METHODS:Totally 66 cases (70 eyes) of patients with primary angle - closure glaucoma with age - related cataract treated in our hospital from February 2014 to February 2017 were selected as the objects of study. Retrospective analysis was implemented to their case data. There were 36 cases (38 eyes) of patients who were treated with phacoemulsification and intraocular lens implantation combined with goniosynechialysis were set as observation group, while the other 30 cases (32 eyes ) of patients who were treated with phacoemulsification and intraocular lens implantation alone were set as control group. Two groups were compared for total success rate of surgery, the situation of eyesight, intraocular pressure, chamber depth and anterior chamber angle before and after surgery, moreover, the occurrences of complications were recorded. ·RESULTS: The absolute success rate of surgery in observation group was 63%, while that of control group was 47%, and the observation group was dramatically higher than control group, with statistical significance(P<0.05). The total success rate of observation group was 87%,while that of control group was 84%, and the difference had no statistical significance (P>0.05). The difference in terms of the number of people whose eyesight were <0.1, 0.1-<0.3, 0.3-0.5 or >0.5 before surgery compared with after surgeries had statistical significance (Zobservation group=7.545, Zcontrol group=7.213; P<0.05),while the difference between groups after surgery had no statistical significance(Z=-1.456,P>0.05). After surgery, the intraocular pressure of both groups decreased significantly(tobservation group=3.323, Pobservation group=0.001; tcontrol group= 10. 394, Pcontrol group<0. 01), and the observation group was significantly lower than control group after surgery, with a difference having statistical significance (t=14.802,P<0.01). Chamber depth of both groups decreased dramatically after surgery (tobservation group= 0. 411, Pobservation group< 0. 01; tcontrol grou=15.621, Pcontrol grou<0. 01), and the difference between groups after surgery had statistical significance (t =15.246,P<0.01). The occurrence rate of complications in observation group was 11%, while that of control group was 25%,and observation group was significantly lower than control group, having statistical significance (x2=4.409,P=0.036). · CONCLUSION: Goniosynechialysis combined with phacoemulsification have obvious efficacy in treating primary angle-closure glaucoma complicated with age-related cataract. It performs better in controlling intraocular pressure after surgery with lower occurrence rate of complication.
ABSTRACT
AIM: To observe the surgical effects of the taumatic lens subluxation and cataract after manual fragmentation and emulsification of nucleus and foldable intraocular lens implantation. METHODS: A 3. 0mm tunnel limbus incision was operated through the predicted bulbar conjunctiva and sclera on 26 cases ( 26 eyes ) with taumatic lens subluxation ( suspensory ligament rupture range less than 120 ) and cataract (Ⅰ ~ Ⅲ) . And after the manual fragmentation and emulsification of nucleus, foldable intraocular lens was implantated. Intraocular lens loop was imbedded in the middle of the lens zonular ligament breakup to reset the pouch. The surgical complications and postoperative vision changes were observed. RESULTS:Three month after operation, 22 eyes had a intraocular lens centric position taking up 85% of the whole. Four eyes had a slightly eccentric position ( 1 ~2mm), taking up 15% of the whole. 21 eyes had their visual acuity 0. 5~0. 8, taking up 81% of the whole. Five eyes of visual acuity was 0. 2~0. 8. Within 24h intraocular pressure of 12 eyes (46%) after operation were elevated, and returned to normal after 2~7d. There was no severe complication during operation and postoperation. CONCLUSION: The manual fragmentation and emulsification of nucleus and foldable intraocular lens implantation of the traumatic lens subluxation and the cataract through the 3. 0mm corneal sclera limbus tunnel incision is a simple and effective surgery.