方法：采用前瞻性随机对照临床试验研究，青光眼合并白内障的患者60例78眼。31例40眼行单切口超声乳化白内障摘除、人工晶状体植入联合小梁切除术，29例 38眼行双切口手术。术后2wk； 1mo观察视力、眼压、术后滤过泡、散光及术后并发症。

结果：术后全部患者都感到视力较术前提高，不同切口组间视力在术后2wk； 1mo比较无显著差异(P>0.05)； 术后2wk； 1mo两组患者的眼压较术前均降低，有显著性差异(P<0.05)，两组间比较无显著性差异(P>0.05)； 单切口组及双切口组功能滤过泡的眼数在术后2wk； 1mo比较均无显著意义(P>0.05)； 术后2wk时，单切口组散光较术前增大，与同期的双切口组相比散光大，均有显著差异(P<0.05)； 术后1mo时，两组与术前相比、两组间比较均无显著差异(P>0.05)； 3眼术后出现少量前房积血，12眼术后早期出现角膜内皮水肿、后弹力层皱褶，6眼出现前房纤维素性渗出。

结论：双切口超声乳化白内障摘除、人工晶状体植入联合小梁切除术治疗青光眼白内障，手术操作简便、疗效佳，是一种理想的手术方式。

METHODS: This prospective, randomized study including 60 patients(78 eyes)with glaucoma and cataract. One-site approach was performed in 31 patients(40 eyes)and two-site approach in 29 patients(38 eyes). Visual acuity, intraocular pressure(IOP), filtration, astigmatism and complications were observed at 2wk and 1mo after operation.

RESULTS: Postoperative visual acuitywas improved in 78 eyes. There was no significant difference of visual acuity between two groups at 2wk and 1mo after operation(P>0.05). The IOP at 2wk and 1mo after operation were lower than that of preoperation in two groups(P<0.05), and there was no significant difference between two groups(P>0.05). The number of eyes with functional filtration has no significant difference between two groups at 2wk and 1mo after operation(P>0.05); 2wk after operation, the astigmatism in one-site approach was bigger than preoperative astigmatism, also bigger than that of two-site approach(P<0.05), and there was no significant difference of astigmatism between two groups at 1mo after operation(P>0.05). There were 3 cases with few hemorrhage in anterior chamber after operation, 12 cases with slight corneal epithelial edema, descemet membrane folds, 6 cases with cellulose exudation in anterior chamber.

CONCLUSION: It is an ideal operation that two-site approachphacoemulsification and intraocular lens implantation combined with trabeculectomy in cataract and glaucoma patients, and has the advantages of simple operation, good treatment effect.