方法：前瞻性研究。选取2019-08/2021-02就诊于我院眼科，诊断为急性闭角型青光眼(APACG)合并年龄相关性白内障患者共80眼。所有患者行白内障超声乳化摘除IOL植入联合术中房角镜直视下房角钝性分离术。观察术前及术后1wk，1、3、6mo最佳矫正视力、眼压、中央前房深度(ACD)、房角开放距离(AOD500)、小梁虹膜夹角(TIA)，并同期行房角镜检查评估房角开放情况，对所得测量值进行统计学分析。

结果：患者术后1wk，1、3、6mo视力与术前相比均提高(P<0.05)，术后各时间点间视力无差异(P>0.05)。术后1wk，1、3、6mo眼压均较术前下降(P<0.05)，术后各时期眼压无差异(P>0.05)。术后1wk，1、3、6mo ACD均较术前有所加深(P<0.05)，术后各时期ACD比较无差异(P>0.05)。术后1wk，1、3、6mo TIA均较术前增宽(P<0.05)。术后各时期TIA比较无差异(P>0.05)。术后1wk，1、3、6mo AOD500均较术前有所增加(P<0.05)，术后各时期AOD500比较无差异(P>0.05)。患者术前上象限、鼻侧象限、下象限及颞侧象限房角宽度与术后1wk，1、3、6mo时相比，宽角眼数明显高于术前，房角宽度构成与术前相比有差异(P<0.05)。

结论：超声乳化白内障摘除IOL植入联合术中钝性房角分离术治疗急性闭角型青光眼合并年龄相关性白内障，可显著提高视力，降低眼压，增加中央前房深度，开放房角，且术后效果稳定，是一种有效的手术方法。

METHODS: A prospective study. Totally 80 eyes with acute primary angle-closure glaucoma(APACG)and cataract were selected in our hospital from August 2019 to February 2021. All study underwent phacoemulsification IOL implantation and goniosynechialysis. Visual acuity, IOP, anterior chamber distance(ACD), trabecular iris angle(TIA)and angle opening distance(AOD500)were measured before and 1wk, 1, 3 and 6mo after surgery. Four quadrant angle classifications of upper, lower, nasal and temporal were determined by Scheie classification method and the measured values were statistically analyzed.

RESULTS: The postoperative corrected visual acuity in 1wk, 1, 3 and 6mo were improved than preoperative, there were no statistically significant differences between each postoperative period(P>0.05). The IOP in postoperative 1wk, 1, 3 and 6mo were reduced than preoperative, there were not significantly different between each postoperative period(P>0.05). The ACD in postoperative 1wk, 1, 3 and 6mo were deepen than preoperative, there were not significantly different between each postoperative period(P>0.05). The TIA in postoperative 1wk, 1, 3 and 6mo were widened than preoperative, there were not significantly different between each postoperative period(P>0.05). The AOD500 in postoperative 1wk, 1, 3 and 6mo were increased than preoperative, there were not significantly different between each postoperative period(P>0.05). The depth of anterior chamber angle in four quadrants were deepened combined with the depth in postoperative 1wk, 1, 3 and 6mo(P<0.05).

CONCLUSION: Phacoemulsification IOL implantation and goniosynechialysis in the treatment of acute angle-closure glaucoma with cataract can significantly improve visual acuity, increase the depth of central anterior chamber, open angle, reduce IOP. It is an effective and stable surgical method.