青光眼滤过手术患者超声乳化白内障吸除术后血-房水屏障功能的改变  

Changes of blood-aqueous barrier after phacoemulsification in patients with previous glaucoma filtering surgery

作　　者：罗莉霞[1] 刘奕志[1] 葛坚[1] 张新愉[1] 刘玉华[1] 吴明星[1] 

机构地区：[1]中山大学中山眼科中心,广州510060

出　　处：《中华眼科杂志》2005年第2期132-135,共4页Chinese Journal of Ophthalmology

摘　　要：目的从血房水屏障功能方面评价青光眼滤过手术后白内障患者行超声乳化白内障吸除人工晶状体植入术的安全性。方法分别对40例(46只眼)青光眼滤过手术后白内障患者(试验组)和60例(64只眼)老年性白内障患者(对照组)行超声乳化白内障吸除人工晶状体植入术,使用激光蛋白细胞检测仪(LFCM)定量检测术前和术后1、7、30、90d房水蛋白浓度的变化,并进行比较。结果超声乳化白内障吸除人工晶状体植入术前及术后1、7、30、90d术眼平均房水闪光值试验组分别为(1512±287)、(4024±375)、(2433±338)、(2118±177)、(1651±170)光粒子数(PC)/ms,差异有统计学意义(P<005);对照组分别为(694±234)、(2627±1021)、(1396±644)、(907±267)、(716±189)PC/ms,差异有统计学意义(P<005)。其中2组术后1、7、30d均高于术前(P<005);术后90d与术前比较,差异均无统计学意义(P>005)。术前和术后1、7、30、90d2组平均房水闪光值比较,差异均有统计学意义(P<005)。试验组术后1d和30d与术前平均房水闪光值的差值均高于对照组(P<005)。结论青光眼滤过手术后患者血房水屏障功能紊乱;超声乳化白内障吸除人工晶状体植入术治疗青光眼滤过手术后白内障患者具有安全性,但加强抗炎性反应治疗,减轻手术损伤,是保证手术安全性的关键。Objective To evaluate the effect of trabeculectomy and/or phacoemulsificationon surgery on blood-aqueous barrier function. Methods Phacoemulsification with implantation of intraocular lens was performed on 46 cataract eyes of 40 glaucoma patients following previous trabeculectomy (group 1), and 64 cataract eyes of 60 patients (group 2). The aqueous flare and cells were examined preoperatively and on days 1, 7, 30,90 postoperatively using a laser flare-cell meter (LFCM).Results The mean aqueous flare values were(15.12±2.87)、(40.24±3.75)、(24.33±3.38)、(21.18±1.77)、(16.51±1.70)photon counts/ms in group 1 preoperatively and on days 1, 7, 30, 90 after surgery (P<0.05) respectively;and were(6.94±2.34)、(26.27±10.21)、(13.96±6.44)、(9.07±2.67)、(7.16±1.89)photon counts/ms in group 2 (P<0.05) respectively.Conclusions Trabeculectomy can breakdown blood-aqueous barrier permanently while phacoemulsification damage the blood-aqueous barrier transiently. Phacoemulsification combined with a previous trabeculectomy can enhance this damage.(Chin J Ophthalmol,2005,41:132-135)

关 键 词：青光眼滤过手术 超声乳化白内障吸除术 血房水屏障 眼蛋白质类 

分 类 号：R779.66[医药卫生—眼科]