摘要目的:评价前房角镜下前房角分离联合晶状体超声乳化术(Phaco-GSL)治疗伴白内障的原发性闭角型青光眼(PACG)的效果。方法:前瞻性随机对照研究。将2020年1月至2020年12月广西壮族自治区人民医院收治的伴白内障的PACG患者54例(54眼)随机分成两组，均行超声乳化术。观察组29眼在前房角镜下进行前房角分离术，对照组25眼在非前房角镜下进行前房角分离术。术后随访3个月，对比两组的手术效果。结果:术后两组的视力均较术前提高( P<0.05)；术后1个月，两组的视力相比，差异无统计学意义。术后3个月，观察组的视力优于对照组( t＝2.90， P＝0.005)。术后两组的眼压均较术前降低( P<0.05)；观察组眼压均低于对照组( t＝14.18，2.90； P<0.001，0.005)。术后1个月及3个月，两组的周边虹膜前粘连范围均较术前减少，观察组周边虹膜前粘连范围均小于对照组( t＝2.81，2.71； P＝0.006，0.008)。 结论:Phaco-GSL可有效降低伴发白内障的原发性闭角型青光眼患者的眼压，前房角镜下的前房角分离术的降眼压及开放前房角的效果均优于非前房角镜下的前房角分离术。

abstractsObjective:To evaluate the efficacy of ultrasonic phacoemulsification combined with gonioscopic goniosynechialysis in the treatment of primary angle-closure glaucoma (PACG) with cataract.Methods:This was a prospective randomized controlled study. A total of 54 eyes of 54 patients with PACG combined with cataract from Jan.2020 to Dec.2020 in the People’s Hospital of Guangxi Zhuang Autonomous Region were collected.All cases were randomly divided into the two groups. In the observation group, 25 eyes underwent gonioscopic goniosynechialysis, while 29 eyes in the control group underwent goniosynechialysis without the guide of goniscope. All cases underwent phacoemulsification. The follow-up time was 3 months after surgery. The surgical efficacy between the two groups were compared.Results:After operation, the BCVA of the two groups were better compared with those before operation ( P<0.05). At 1month after operation, the difference of BCVA were not significantly significant between the two groups. At 3 months after operation, the BCVA of the observation group was better than that of the control group ( t=2.90, P=0.005). After operation, the IOP of the two groups were lower than those before operation ( t=14.18, 2.90; P<0.001, 0.005); the IOP of the observation group was lower than that of the control group ( P<0.05). At 1 and 3 months after operation, the range of PAS in both groups was reduced compared with those before operation, and the range of PAS in the observation group was smaller than that in the control group ( t=2.81, 2.71; P=0.006, 0.008). Conclusion:Ultrasonic phacoemulsification combined with goniosynechialysis can effectively reduce the IOP in patients with PACG combined with cataract.The effect of phacoemulsification combined with gonioscopic goniosynechialysis is better than that without the guide of goniscope.