超声生物显微镜对原发性闭角型青光眼合并白内障患者眼前节结构变化的观察  

Imaging of the anterior chamber by ultrasound biomicroscopy before and after cataract surgery in eyes with primary angle closure glaucoma

作　　者：曹春林[1] 黄振平[1] 王理理[1] 薛春燕[1] 史继新[2] 

机构地区：[1]南方医科大学南京临床医学院(南京军区南京总院)眼科,江苏南京210002 [2]南方医科大学南京临床医学院(南京军区南京总院)神经外科,江苏南京210002

出　　处：《医学研究生学报》2009年第2期169-172,共4页Journal of Medical Postgraduates

基　　金：南京军区医药卫生科研基金资助项目(批准号:07M086)

摘　　要：目的:应用超声生物显微镜(UBM)观察原发性闭角型青光眼合并白内障患者超声乳化摘除联合人工晶体植入术前后的眼前节结构变化。方法:对50例78只眼原发性闭角型青光眼合并白内障患者,实施单纯白内障超声乳化摘除联合人工晶体植入术,手术前及术后1个月进行UBM检查,观察眼前节结构的变化,同时监测手术前后的眼压和术后疗效。结果:UBM检查结果显示,所有患者手术后中央前房深度(ACD)、房角开放距离500(AOD500)、小梁虹膜夹角、小梁睫状体距离(TCPD)与术前比较,差异均有非常显著性统计学意义(P<0.01);巩膜睫状体夹角与术前比较,差异有显著性统计学意义(P<0.05),虹膜厚度(IT)、虹膜悬韧带距离(IZD)、虹膜晶状体夹角与术前比较无显著性差异(P>0.05)。在脱离药物治疗后,手术后眼压稳定在正常范围(10～21mmHg),视力均好于手术前。结论:单纯性白内障超声乳化联合人工晶体植入术可使房角尚未完全粘连的原发性闭角型青光眼患者的眼房角开放、前房加深,有效控制眼压。利用UBM检查可快速、有效、准确地观察眼前节结构,有助于早期进行手术。Objective： To observe the changes in the anterior chamber before and after cataract surgery by ultrasound biomicroscopy （UBM） in eyes with primary angle closure glaucoma. Methods： Ultrasound biomicroscopy was used for anterior chamber imaging in 78 eyes of 50 patients with primary angle closure glaucoma before and 1 month after cataract phacoemulsification and intraocular Xens implantation. And the intraocular pressures were recorded at the same time. Results ： UBM allowed the imaging of the entire anterior eye segment. In the images, the differences between iris thickness （IT）, iris zonule distance （IZD） and iris lens angle （02） before and after the operation were statistically insignificant. After the operation, marked increases were observed in the anterior chamber depth （ACD） , angle opening distance at 500 μm from the scleral spur （AOD500）, trabecular iris angle （01） and trabecular ciliary process distance （TCPD）, with statistically very significant differences from preoperation （P 〈 0.01 ）. Scleral ciliary body angle （θ3） was also increased （P 〈 0.05）. The intraocular pressures were normal after the withdrawal of medication postoperatively. Visual acuity was improved in all the patients after the operation. Conclusion： Primary angle closure glaucoma can be successfully managed by cataract phacoemulsification, which, at the early stage of the disease, can deepen the anterior chamber, widen the chamber angle and reopen the trabeculae. UBM is very helpful to the operation by providing rapid images of the anterior eye segment.

关 键 词：超声生物显微镜 青光眼 白内障 

分 类 号：R776.1[医药卫生—眼科] R775[医药卫生—临床医学]