目的：探讨飞秒激光辅助白内障超声乳化联合房角分离术治疗原发性急性闭角型青光眼合并白内障的临床疗效。

方法：选取2020-04/2021-02我院收治的原发性急性闭角型青光眼合并白内障患者53例60眼，根据手术方式进行分组，A组28例30眼行飞秒激光辅助白内障超声乳化吸除联合房角分离术，B组25例30眼行传统白内障超声乳化吸除联合房角分离术。记录两组术中有效超声乳化时间(EPT)和超声乳化累积耗散能量(CDE)，随访至术后3mo，观察两组眼压、前房深度(ACD)、最佳矫正视力、角膜内皮细胞丢失率(ECL)及手术并发症情况。

结果：与术前相比，两组术后眼压显著降低，ACD显著加深(均P<0.05)，但两组间眼压和ACD均无差异(均P>0.05)； 两组术后最佳矫正视力显著优于术前(P<0.05)，且术后1d时A组显著优于B组(P<0.05)； A组术中EPT和CDE、术后ECL及并发症发生率(7% vs 27%)均显著低于B组(均P<0.05)。

结论：飞秒激光辅助白内障超声乳化联合房角分离术治疗原发性急性闭角型青光眼合并白内障治疗效果显著，可有效提高手术安全性，降低角膜内皮细胞丢失率，且并发症少。

METHODS: A total of 53 patients(60 eyes)with primary acute angle closure glaucoma complicated with cataract admitted to our hospital from April 2020 to February 2021 were selected. They were divided into two groups according to the surgical method, with 28 cases(30 eyes)who were treated with femtosecond laser-assisted phacoemulsification combined with goniosynechialysis in group A, and 25 cases(30 eyes)who were treated with traditional cataract phacoemulsification combined with goniosynechialysis in group B. The effective phacoemulsification time(EPT)and cumulative dissipated energy(CDE)during surgery in two groups were recorded. Patients were followed up to 3mo after surgery, and the intraocular pressure, anterior chamber depth(ACD), best corrected visual acuity, corneal endothelial cell loss rate(ECL)and surgical complications were observed in both groups.

RESULTS: The postoperative intraocular pressure was significantly decreased and ACD was significantly increased(all P<0.05), and there was no difference between the two groups(all P>0.05). The postoperative best corrected visual acuity of the two groups was significantly better than that before surgery(P<0.05), and group A was significantly better than group B at 1d after surgery(P<0.05). The EPT, CDE, ECL and incidence of complications(7% vs. 27%)in group A were significantly lower than those in group B(all P<0.05).

CONCLUSION: Femtosecond laser-assisted cataract phacoemulsification combined with goniosynechialysis in the treatment of primary acute angle-closure glaucoma combined with cataract has a significant therapeutic effect, which can effectively improve surgical safety, reduce the rate of corneal endothelial cell loss, and have fewer complications.