Abstract：
To explore the clinical efficacy of quadruple surgery (anterior segment pars plana vitrectomy + phacoemulsification + posterior capsulorhexis + intraocular lens (IOL) implantation + trabeculectomy) and dual surgery (phacoemulsification + IOL implantation + trabeculectomy) to treat medically uncontrolled acute primary angle-closure glaucoma (APACG). The clinical data of 44 patients (45 eyes) with APACG treated in the Department of Ophthalmology of Taihe Hospital were retrospectively analyzed. They were divided into 2 groups based on quadruple surgery and dual surgery. There were 20 patients (20 eyes) underwent quadruple surgery in group A. And there were 24 patients (25 eyes) dual surgery in group B. The changes in intraocular pressure (IOP), visual improvement, and complications were observed between the 2 groups preoperatively and 1 month, 3 months, and 6 months postoperatively. Preoperative best corrected visual acuity (BCVA) was the influencing factor of postoperative BCVA at 1 month, 3 months and 6 months. Before surgery, the mean IOP of group A was significantly higher than that of group B (P < .001), and no significant difference was found in the BCVA, age, gender, eyes, axial length (AL), anterior chamber depth (ACD) (PBCVA = 0.12, Page = 0.76, Peyes = 0.20, Pgender = 0.37, PAL = 0.94, PACD = 0.08). On comparison at postoperative 1week, there was no significant difference in the IOP and BCVA between the 2 groups (PIOP = 0.64, PBCVA = 0.66). The mean IOP of group A was significantly lower than that of group B 1 month, 3 months, and 6 months postoperatively (P1month = 0.002, P3months < 0.001, P6months < 0.001). The degree of visual acuity recovery was significantly higher in group A at 1 month, 3 months, and 6 months postoperatively (P1month = 0.03, P3months = 0.02, P6months = 0.02). During treatment, the incidence of complications in group B was significantly higher than that in group A (P < .01). The clinical efficacy of anterior segment pars plana vitrectomy combined with posterior capsulorhexis, phacoemulsification, and trabeculectomy elicits clinical safety in treating medically uncontrolled APACG. It has remarkable effects and leads to a significant decrease in the occurrence of complications.
摘要：
探讨四联手术(眼前段玻璃体切割+超声乳化+后囊撕破+人工晶状体(IOL)植入术+小梁切除术)和双联手术(超声乳化+IOL植入术+小梁切除术)治疗药物控制的急性原发性闭角型青光眼(APACG)的临床疗效。回顾性分析太和医院眼科收治的44例(45眼)APACG患者的临床资料。根据四联手术和双联手术分为两组。A组20例(20只眼)行四联手术,B组24例(25只眼)行双联手术。视觉改善，观察两组术前、术后1个月的并发症,3个月,术后6个月。术前最佳矫正视力(BCVA)是术后1个月BCVA的影响因素,3个月和6个月。手术前,A组平均眼压明显高于B组(P<.001),在BCVA中没有发现显着差异，年龄,性别,眼睛,轴向长度（AL），前房深度(ACD)(PBCVA=0.12,Page=0.76,Peyes=0.20,Pgender=0.37,PAL=0.94,PACD=0.08)。术后1周比较，两组间眼压和BCVA差异无统计学意义(PIOP=0.64,PBCVA=0.66)。A组1个月的平均眼压明显低于B组,3个月,术后6个月（P1个月=0.002，P3个月<0.001，P6个月<0.001）。1个月时A组视力恢复程度明显高于对照组,3个月,术后6个月（P1个月=0.03，P3个月=0.02，P6个月=0.02）。治疗期间,B组并发症发生率明显高于A组（P＜0．01）。前段平坦部玻璃体切除术联合后囊撕除术的临床疗效,白内障超声乳化术,小梁切除术在治疗药物不控制的APACG方面具有临床安全性。它具有显着的效果，并导致并发症的发生显着减少。
