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@#AIM:To observe the effect of phacoemulsification and intraocular lens(IOL)implantation combined with trabeculectomy on the central anterior chamber depth(ACD)and astigmatism of patients with cataract and glaucoma.<p>METHODS:This prospective study included 100 patients(100 eyes)with cataract and glaucoma who were admitted to the hospital between November 2018 and November 2019. The patients were divided into control group(<i>n</i>=50, 50 eyes)and observation group(<i>n</i>=50, 50 eyes)by the random number table method. The control group was treated with phacoemulsification and IOL implantation, while the observation group was treated with phacoemulsification and IOL implantation combined with trabeculectomy. The LogMAR visual acuity, intraocular pressure(IOP), ACD and astigmatism at 1wk, 2wk and 1mo after operation, visual quality, and the incidence of complications were compared between the two groups. <p>RESULTS:Compared with preoperative, the ACD of the two groups increased, LogMAR visual acuity and IOP decreased at 1wk, 2wk and 1mo after operation(<i>P</i><0.05). Moreover, the ACD of the observation group at 1wk, 2wk and 1mo after operation were higher than those of the control group, and the LogMAR visual acuity, IOP was lower than that of the control group(<i>P</i><0.05). The astigmatism of the two groups increased at 1,2wk after operation, and obseration group decreased at 1mo after operation(<i>P</i><0.05). Meanwhile, the astigmatism of the observation group was lower than that of the control group(<i>P</i><0.05). At 1mo after operation, the scores of watching TV, reading and writing, and fine operation of the observation group were higher than those of the control group(<i>P</i><0.05). The incidence of complications in the observation group was lower than that in the control group(6% <i>vs </i>22%, <i>P</i><0.05). <p>CONCLUSION:Phacoemulsification and IOL implantation combined with trabeculectomy is markedly effective in the treatment of patients with cataract and glaucoma, which can improve vision and visual quality. Lower intraocular pressure and astigmatism, reduce changes in astigmatism, deepen the central anterior chamber depth, and reduce the incidence of complications.
RESUMEN
@#AIM:To explore the effects of EX-PRESS glaucoma drainage device implantation and trabectome on visual acuity, intraocular pressure, central anterior chamber depth(ACD)and postoperative complications in patients with primary open angle glaucoma(POAG)complicated with cataract. <p>METHODS: The clinical data of 64 patients(64 eyes)with POAG complicated with cataract in our hospital from March 2015 to January 2017 were retrospectively analyzed. Among them, 34 patients(34 eyes)were given EX-PRESS glaucoma drainage device implantation and cataract phacoemulsification(the Group A)and another 30 cases(30 eyes)were given trabectome combined with cataract phacoemulsification(the Group B). The visual acuity \〖best corrected visual acuity(BCVA)\〗, intraocular pressure, ACD and the thickness of macular ganglion cell complex(GCC)were compared between the two groups before operation and at 5mo after operation, and the differences of postoperative complications were also recorded between the two groups. <p>RESULTS: At 5mo after operation, the BCVA, intraocular pressure(IOP)was lower than that before operation(<i>t</i> <sub>Group A</sub>=39.359, 21.045; <i>t</i> <sub>Group B</sub>=23.126, 16.863; <i>P</i><0.01), and the Group A was lower than that in the Group B(<i>t</i>=9.452, 2.761; <i>P</i><0.01). There was no significant difference in the ACD level before and after operation between-groups and within-groups(<i>P</i>>0.05). At 5mo after operation, there was no significant difference in the thickness of macular GCC in the Group A compared with that before operation(<i>P</i>>0.05), but the thickness of macular GCC in the Group B was lower than that before operation(<i>t</i>=3.851, <i>P</i><0.05)and was lower than that in the Group A(<i>t</i>=2.269, <i>P</i><0.05). The incidence rate of postoperative complications in the Group A was significantly lower than that in the Group B(<i>χ</i><sup>2</sup>=7.883, <i>P</i><0.05). <p>CONCLUSION: EX-PRESS glaucoma drainage device implantation or trabectome combined with cataract phacoemulsification can receive good treatment effects in treating POAG patients with cataract, but the former one has better effects on reducing IOP and improving visual acuity than those in the latter one. And EX-PRESS glaucoma drainage device implantation can reduce the incidence rate of postoperative complications, and it is also beneficial to the reduction of retinal ganglion cells(RGCs)damage and the disease prognosis.