急性闭角型青光眼的临床体征与房角粘连程度的关系  

The relationship between clinical signs of acute primary angle-closure glaucoma and the extent of angle synechiae closure

作　　者：梁远波[1] 吴作红[2] 王宁利[1] 乔利亚[1] 王兰[1] 孙霞[1] 

机构地区：[1]首都医科大学北京同仁眼科中心,北京100730 [2]中山大学中山眼科中心,广东广州510060

出　　处：《眼视光学杂志》2006年第3期177-179,共3页Chinese Journal of Optometry & Ophthalmology

基　　金：国家十五科技攻关资助项目(2003BA712A11-18)

摘　　要：目的探讨原发性闭角型青光眼急性发作时的临床体征与房角粘连关闭程度之间的相关性。方法对2002年-2003年收治住院的117例（126眼）原发性急性闭角型青光眼患者进行了回顾性分析。分析了患者的眼压、角膜水肿情况、瞳孔改变、虹膜萎缩、视神经损害等体征与房角粘连关闭程度之间的相关关系。结果108眼（占85．7％，108／126）在用药眼压下降后进行了房角镜检查。房角关闭范围不足1／2圆周的有52眼（占41．3％，52／126），1／2～3／4圆周的有4眼（占3．1％，4／126），房角关闭大于3／4圆周的有52眼（占41．3％，52／126）。患者的眼压及角膜水肿情况、瞳孔改变、虹膜萎缩等眼前段体征与房角粘连关闭程度之间无相关关系（P〉0．05）。视神经的损害程度与房角粘连关闭程度呈一定的正相关关系（P〈0．05）。结论眼压及角膜水肿情况、瞳孔改变、虹膜萎缩等眼前段体征与房角粘连程度不具有明显相关性。急性闭角型青光眼的手术方案的选择仍应参考房角镜的检查情况。Objective To investigate the correlation between the signs of acute primary angle-closure glaucoma （PACG） and the extent of angle-closure.Methods One hundred and eight among 117 cases of acute PACG （from 2002 - 2003） were reviewed retrospectively in our hospital. Intraocular pressure （IOP） peak, corneal edema, pupil size, iris atrophy, and degree of optic nerve damage were recorded to correlate with the extent of angle .synechiae-closure measured with dynamic gonioscopy. Results Angle-closure less than 1/2 circle was found in 52 eyes （41.3% ,52/126）, 1/2- 3/4 circle in 4 eyes （3.1% ,4/126）, 〉3/4 circle in52 eyes （41.3% ,52/126）. There was no significant correlation between the clinical signs and the extent of angle-closure （ P 〉 0.05 ）. However, the degree of optic nerve was significantly associated with the extent of angle-closure （ P 〈 0.05 ）. Conclusion The signs of acute PACG including IOP level, corneal edema, change of pupil, and iris atrophy appear not to be a reliable indicator for the extent of pre-phoral anterior .synechia.

关 键 词：青光眼 闭角型 眼/外科手术 手术指征 

分 类 号：R775.2[医药卫生—眼科]