青光眼白内障联合术后SITA视野变化的临床观察  

Observation ofSITA perimetry change after combined phaco-trabeculectomy

作　　者：杨瑾[1] 刘爱华[1] 孙慧敏[1] 李筱荣[1] 

机构地区：[1]天津医科大学眼科中心,天津300070

出　　处：《中国实用眼科杂志》2009年第4期353-355,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的评价青光眼合并白内障患者，青光眼白内障联合术后SITA（瑞典交互式阂值算法）视野变化情况。方法回顾性非对照性研究，32例（37只眼）原发性开角型或闭角型青光眼，合并白内障行白内障青光眼联合手术患者手术前后行标准SITA24—2视野检查，评估平均偏差（MD）及模式标准差（PSD）的变化，同时观察手术前后最佳矫正视力、眼压及青光眼用药情况。结果32例（37只眼）最佳矫正视力从术前0．32±0．16提高至0．58±0．21（P〈0．05），抗青光眼用药量从术前2．16±0．73降至术后0（P〈0．05），眼压从术前（23．32±10．69）mmHg降至（11．73±3．28）mmHg，（P〈0．05）。手术前后比较具有统计学意义。视野平均偏差（MD）从术前（-14．12±9．37）增加至术后（-13．61±9．21）（P〈0．05）。模式标准差（PsD）从术前（6．41±3．92）至术后（6．38±3．89）（P〉0．05）。结论青光眼合并白内障患者青光眼白内障联合术后MD变化差异有统计学意义，但PSD变化差异无统计学意义，青光眼患者SITA检测的PSD值未受晶状体混浊的影响，数值相对稳定，可以在青光眼合并白内障患者的随访中作为观察青光眼进展的重要指标。Objective To evaluate the effect of combined phaco-trabeculectomy on SITA（Swedish Intractive Thresholding Algorithm）perimetry in patient with coexisting cararact and glaucoma. Methods This is a retrospective noncomparative interventional study.Thirty-two consecutive patients （37eyes）with primary open-angle glaucoma or primary angle closure glaucoma who had cataract extraction combined with trabeculectomy were included. All patients had SITA-standard 24-2 visual fields before and after the surgery.The main outcome measures were changes in mean deviation（MD ）and pattern standard deviation （PSD）.Additionally changes in best-corrected visual acuity（BCVA ）, intraocular pressure and number of glaucoma medications were also studied.Result mean best-corrected visual acuity improved after surgery from 0.32± 0.16 to 0.58± 0.21 （P 〈0.05）,the median number of antiglaucoma medications from 2.16± 0.73 to 0 （P 〈0.05）,and in- traocular pressure from 23.32± 10.69 mmHg to 11.73± 3.28 mmHg（P 〈0.05 ）, after cataract extraction, SITA standard mean MD improve from-14.12± 9.37 to -13.61± 9.21 （P 〈0.05）,whereas the change in mean PSD was statistically nonsignificant（from 6.41± 3.92 to 6.38± 3.89,P 〉0.05）.Conclusions In glaucoma patients examined with SITA-standard, MD improve but PSD changed was statistically nonsignificant after combined phaco-trabeculectomy .SITA-standard PSD can be used to monitor glaucoma progression in patients with coexisting glaucoma and cataract.

关 键 词：视野 青光眼 白内障 SITA 

分 类 号：R775[医药卫生—眼科] R778.3[医药卫生—临床医学]