目的：对比分析原发性急性闭角型青光眼(APACG)合并早期白内障患者行白内障超声乳化联合房角黏连分离术(GSL+PPI术)及小梁切除术后的生活质量并分析相关因素。

方法：前瞻性随机性病例对照研究。将符合纳入标准的APACG患者分为A(PPI+GSL术组，29例)、B(小梁切除术组，30例)两组，术后随访6mo，采用NEI-VFQ-25量表评估生活质量，同时记录患者眼压、最佳矫正视力(BCVA)、返院复查频率及基本信息。

结果：术后6mo，两组眼压均较术前降低，A组BCVA较术前明显改善(均P<0.05)，B组手术前后BCVA无明显差异(P>0.05)，且B组复诊频率高于A组(P< 0.05)。两组术后NEI-VFQ-25量表评分均较术前增高(均P<0.05)，与B组比较，A组术后总体视觉、眼痛、远距离工作、社交功能、角色限制等方面的生活质量评分更高，且A组术后生活质量评分提高的幅度较B组更高(P<0.05)，其与A组术后BCVA改善及复查频率较少有关(R²=0.48，F=5.00，P<0.05)。

结论：与小梁切除术相比，PPI+GSL术后APACG合并早期白内障患者能获得更好的生活质量。

METHODS: A perspective, randomized case-control study was conducted. Patients with acute primary angle-closure glaucoma(ACG)and early cataracts underwent PPI+GSL implantation(group A, n=29)and trabeculectomy(group B, n=30). The quality of life was assessed using the National Eye Institute 25-Item Visual Function Questionnaire(NEI-VFQ-25)before and 6mo after surgery. Intraocular pressure(IOP), best corrected visual acuity(BCVA), review frequency and the basic characteristics were recorded simultaneously.

RESULTS: Compared with preoperative status, the IOP in both groups was significantly decreased(all P<005), and the BCVA was significantly increased in group A(P<0.05), while did not differ significantly in group B(P>0.05). Besides, group B presented higher review frequency than group A(P<0.05). Moreover, significant increases in postoperative scores were founded in the two groups respectively(all P<0.05). Compared with group B, group A had better postoperative performance in items of general vision, ocular pain, long-distance activities, social functioning and role limitations(all P<0.05). Besides, group A presented significantly higher net increases in postoperative total scores than group B(P<0.05), which was positively associated with the degree of the BCVA recovery and negatively associated with review frequency(R²=0.48, F=5.00, P<0.05).

CONCLUSION: APACG patients with early cataracts, PPI+GSL determines better improvement in quality of life compared to trabeculectomy.