急慢性闭角型青光眼患者角膜细胞形态学特征及其与手术疗效相关性分析
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摘要
目的研究急慢性闭角型青光眼患者角膜细胞形态学特征及其与手术疗效的相关性。方法回顾性分析2016年1月至2017年12月该院接诊的60例闭角型青光眼患者的诊疗情况,将所有患者分为研究组和对照组,每组各30例,依据闭角型青光眼的分型,将患者分为急性亚组与慢性亚组。研究组患者行超声乳化手术治疗,对照组患者行小梁切除术治疗。对两组患者手术前后眼压水平、前房深度改变情况、前房角改变情况、角膜内皮细胞指标及并发症情况进行观察比较。结果术前,研究组和对照组的急性亚组与慢性亚组患者眼压水平及前房深度比较,差异均无统计学意义(P>0.05)。手术后1年,研究组和对照组的急性亚组与慢性亚组患者眼压水平均明显降低,且研究组患者眼压水平降低情况明显优于对照组,差异均有统计学意义(P<0.05);研究组的急性亚组和慢性亚组患者前房深度均较术前明显升高,且研究组患者前房深度升高情况明显优于对照组,差异均有统计学意义(P<0.05)。研究组和对照组的急性亚组与慢性亚组间最大细胞面积、最小细胞面积、单位面积细胞密度、平均细胞面积、细胞面积的变异系数及平均细胞面积标准差比较,差异均无统计学意义(P>0.05);研究组和对照组的急性亚组六角细胞比例明显低于慢性亚组,差异有统计学意义(P<0.05)。手术后研究组和对照组的慢性亚组与急性亚组并发症发生率比较,差异无统计学意义(P>0.05)。结论早期及时采用超声乳化手术对青光眼患者进行治疗,可明显改善角膜细胞形态,可提高治疗效果,值得临床推广应用。
Objective To study the morphological characteristics of corneal cells in patients with acute and chronic angle closure glaucoma and its correlation with surgical outcome.Methods A total of 60 cases of angle closure glaucoma received in the hospital from January 2016 to December 2017 were studied,and then the patients were divided into two subgroups in the acute and chronic groups with 30 cases in each group according to the classification of angle closure glaucoma.Patients in the study group were treated by phacoemulsification.Trabeculectomy was performed in patients in the control group.The intraocular pressure level,the change of anterior chamber depth,the change of anterior chamber angle,corneal endothelial cell index and complications were observed and compared before and after operation in the two groups.Results There was no significant difference in intraocular pressure and anterior chamber depth between the acute group and the control group before operation(P>0.05).1 year after the operation,the level of intraocular pressure in the acute and chronic group of the study group and the control group were significantly lower than those in the control group,and the decrease of the level of intraocular pressure in the study group were significantly better than those in the control group,and the difference was statistically significant(P<0.05).The depth of anterior chamber in the acute and chronic group of the study group was significant higher than that before operation,and which in study group was higher than that in control group(P<0.05).There were no significant difference in MAX,MIN,CD,AVG,CVand s between the acute subgroup and the chronic subgroup between the study group and the control group(P>0.05).The six corner cells in the acute subgroup of the study group and the control group were significantly lower than those of the chronic subgroup,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of complications between the study group and the control group after the operation(P>0.05).Conclusion The early use of phacoemulsification in the treatment of glaucoma patients can significantly improve the morphology of corneal cells to improve the effect of treatment,which is worthy of clinical application.
Objective To study the morphological characteristics of corneal cells in patients with acute and chronic angle closure glaucoma and its correlation with surgical outcome.Methods A total of 60 cases of angle closure glaucoma received in the hospital from January 2016 to December 2017 were studied,and then the patients were divided into two subgroups in the acute and chronic groups with 30 cases in each group according to the classification of angle closure glaucoma.Patients in the study group were treated by phacoemulsification.Trabeculectomy was performed in patients in the control group.The intraocular pressure level,the change of anterior chamber depth,the change of anterior chamber angle,corneal endothelial cell index and complications were observed and compared before and after operation in the two groups.Results There was no significant difference in intraocular pressure and anterior chamber depth between the acute group and the control group before operation(P>0.05).1 year after the operation,the level of intraocular pressure in the acute and chronic group of the study group and the control group were significantly lower than those in the control group,and the decrease of the level of intraocular pressure in the study group were significantly better than those in the control group,and the difference was statistically significant(P<0.05).The depth of anterior chamber in the acute and chronic group of the study group was significant higher than that before operation,and which in study group was higher than that in control group(P<0.05).There were no significant difference in MAX,MIN,CD,AVG,CVand s between the acute subgroup and the chronic subgroup between the study group and the control group(P>0.05).The six corner cells in the acute subgroup of the study group and the control group were significantly lower than those of the chronic subgroup,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of complications between the study group and the control group after the operation(P>0.05).Conclusion The early use of phacoemulsification in the treatment of glaucoma patients can significantly improve the morphology of corneal cells to improve the effect of treatment,which is worthy of clinical application.
引文
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[10]梁裕琴,向浩天.小切口白内障青光眼联合手术临床观察[J].重庆医学,2014,43(13):1576-1578.
[11]宋五德,梁章海.不同前房深度急性闭角型青光眼持续高眼压患者的手术疗效分析[J].眼科新进展,2014,34(4):366-368.
[12]王琛.青光眼术后行白内障超声乳化吸出术后眼内压和角膜内皮细胞完整性的改变[J].哈尔滨医科大学学报,2014,48(1):40-43.
[2]赵燕,常英霞,王国强,等.超声乳化白内障吸除联合小梁切除术对急性闭角型青光眼合并老年性白内障的疗效及安全性[J].中国老年学杂志,2016,36(20):5118-5119.
[3]冯希敏,祁颖,张凤妍,等.超声乳化人工晶状体植入联合房角分离术治疗急性原发性闭角型青光眼合并年龄相关性白内障患者的疗效分析[J].眼科新进展,2016,36(8):767-769.
[4]高佳,郝燕燕,杨鑫,等.原发性闭角型青光眼两种术式临床疗效的比较[J].郑州大学学报(医学版),2016,51(4):559-561.
[5]毕宇,葛红岩,刘平.不同手术方式对原发性闭角型青光眼合并白内障的疗效分析[J].眼科新进展,2015,35(5):442-445.
[6]伏小甜,于永斌.不同青光眼治疗方法对角膜内皮影响的研究进展[J].眼科新进展,2016,36(1):92-94.
[7]侯旭,胡丹,崔志利,等.微创小梁切除联合晶状体超声乳化术治疗急性闭角型青光眼合并白内障的6个月效果[J].眼科,2015,24(1):31-34.
[8]辛晨,汪军,刘广峰,等.青光眼微创手术进展[J].眼科新进展,2015,35(1):92-97.
[9]杨彬,孙红.急性原发性闭角型青光眼与慢性原发性闭角型青光眼的临床特征分析[J].南京医科大学学报(自然科学版),2014,34(12):1725-1727.
[10]梁裕琴,向浩天.小切口白内障青光眼联合手术临床观察[J].重庆医学,2014,43(13):1576-1578.
[11]宋五德,梁章海.不同前房深度急性闭角型青光眼持续高眼压患者的手术疗效分析[J].眼科新进展,2014,34(4):366-368.
[12]王琛.青光眼术后行白内障超声乳化吸出术后眼内压和角膜内皮细胞完整性的改变[J].哈尔滨医科大学学报,2014,48(1):40-43.