Objective To study the different clinical effects between the method ofperipheral iridectomy+trabeculectomy combined with cataract extraction with small incision+intraocular lens implantationand the method ofperipheral iridectomy+trabeculectomy combined with cataract with phacoemulsification+intraocular lens implan-tation,so as to provide guidance for clinic.Methods 40 cases were randomly divided into A and B groups,and A group included 19 patients (31 eyes),while B group included 21 patients (37 eyes).A group was treated with the peripheral iridectomy +trabeculectomy combined with cataract extraction with small incision +intraocular lens implantationmethod,and B group was cured with the method ofperipheral iridectomy+trabeculectomy combined with cataract with phacoemulsification +intraocular lens implantationmethod.In each group,the eye pressures, visual acuity,central anterior chamber depths of before and after treatment were compared to study the clinical effect. And after treatment,the improvement amount of eye pressure,visual acuity,central anterior chamber depths and the complication rates were compared between the two groups,so as to determine the better method.Results After treatment,the eye pressure,visual acuity,central anterior chamber depths in A group were significantly improved [(21.71 ±10.17)mmHg,(0.29 ±0.09)and (1.97 ±0.47)mm,t=11.12,6.93,17.39,all P<0.05].The eye pressure,visual acuity,central anterior chamber depths in B group were significantly improved[(19.45 ±9.54)mmHg, (0.35 ±0.16)and (1.98 ±0.39)mm,t=6.52,5.78,17.78,all P<0.05].After treatment,the eye pressures in A and B groups were cut down[(21.74 ±10.17)and (19.45 ±9.54)mmHg],and there was no statistical significant difference between the two groups (t=0.96,P=0.17).The visual acuity in A and B groups were improved[(0.29 ± 0.09)and (0.35 ±0.16)degrees],and there was no statistically significant difference between the two groups (t=1.86,P=0.97).The central anterior chamber depths in A and B groups were improved[(1.97 ±0.47)and (1.98 ± 0.39)mm],and there was no statistically significant difference between the two groups (t=0.09,P=0.54).The incidence rates of complication in A and B groups were 48.39% and 21.62%,respectively,and the difference between two groups was significant (χ2 =5.44,P=0.02).Conclusion The two treatments had significant and equal clinical effects,while because of its lower incidence rate of complication,the method ofperipheral iridectomy+trabeculectomy combined with cataract with phacoemulsification+intraocular lens implantationis more safe than the other one.

Objective To investigate the changes of component and morphology in internal carotid vulnerable plaque,for helping to make clinical intervention strategy individually. Methods A total of 47 patients with internal carotid vulnerable plaques and primary hypertension underwent 2 high-resolution and multi-contrast MRI scans, from March 2008 to April 2014 were retrospectively reviewed. At baseline, the plaque was mainly located at the proximal internal carotid artery,and maximum plaque thickness ≥1.5 mm with intraplaque hemorrhage(IPH)and(or)thin or ruptured fibrous cap.Interscan interval was 0.5 years and above. Patients with carotid occlusion or surgery were excluded. Morphological measurements included maximum plaque thickness, maximum plaque area and cross-sectional vessel area (CSVA) on the level of plaque with maximum thickness. The paired-samples t test was performed to compare the difference of plaque morphology between baseline and follow-up carotid MRI.Results The interscan interval was 1.83 (1.59,1.99)years for 47 internal carotid vulnerable plaques.One case(interscan interval 2.16 years)showed IPH within those 11 plaques without IPH at baseline,and one case(interscan interval 1.42 years)had new incident IPH within those 36 plaques with IPH at baseline. Maximum plaque thickness increased significantly from(3.94±1.44)mm to(4.24±1.68)mm(t=2.30,P<0.05)by 5.14%(-3.83,11.34)% per year. Maximum plaque area increased significantly from(49.19±21.15)mm2to(56.03±24.91)mm2(t=3.87,P<0.01)by 6.67%(-2.26,19.60)% per year.CSVA increased significantly from(66.22±27.51)mm2to(73.68±31.47)mm2(t=4.08,P<0.01)by 5.18%(-1.63,12.34)% per year.Conclusion The progression of component,burden and outer remodeling in the internal carotid vulnerable plaque may be faster in hypertension, therefore reasonable intervention strategy and regular follow-up carotid MRI should be performed.