Observation on the Efficacy of Three Surgical Methods in the Treatment of Acute Primary Angle-closure Glaucoma with Cataract
Objective:To compare of the therapeutic effects of three surgical methods for acute primary angle-closure glaucoma(PACG)with cataract.Method:A total of 96 patients with acute PACG with cataract who underwent surgical treatment in Nanchang Bright Eye Hospital from February 2020 to February 2023 were selected,and were divided into three groups by random number table method,compound resection group(34 cases),trabeculectomy group(32 cases),and angle separation group(30 cases).Three groups of ophthalmic related parameters,complications,and long-term quality of life were compared.Result:The best corrected visual acuity(BCVA),central anterior chamber depth(CAC),angle open distance 500(AOD500),trabecular iris angle(TIA),quality of life score of patients in the compound resection group were higher than those in the trabeculectomy group and angle separation group(P<0.05);while intraocular pressure(IOP),angle morphology grading,trabecular ciliary processes distance(TCPD)and peripheral anterior synechia(PAS)were lower than those in the trabeculectomy group and angle separation group,the differences were statistically significant(P<0.05);there were no statistically significant differences in peripheral anterior chamber depth grading(PAC),lens thickness(TL),and axial length(AL)among the three groups(P>0.05).There were no statistically significant differences in BCVA,IOP,CAC,PAC,angle morphology grading,TL,AL,AOD500,TIA,TCPD,PAS,and quality of life scores among the trabeculectomy group and angle separation group patients(P>0.05).The total effective rate of patients in the compound resection group was 94.12% (32/34),which was higher than 71.88% (23/32)in the trabeculectomy group and 66.67% (20/30)in the angle separation group,the differences were statistically significant(P<0.05);there was no statistically significant difference in the total effective rate between the trabeculectomy group and angle separation group(P>0.05).The incidence of complications in the compound resection group was 5.88% (2/34),which was lower than 28.13% (9/32)in the trabeculectomy group and 26.67% (8/30)in the angle separation group,the differences were statistically significant(P<0.05);there was no statistically significant difference in the incidence of complications between the trabeculectomy group and angle separation group(P>0.05).Conclusion:The therapeutic effect of acute PACG with cataract phacoemulsification combined with compound trabeculectomy is significant.
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