小梁切除术后视盘形态学变化  

Morphological changes of optic disc after trabeculectomy

作　　者：闫亦农 胡俊[2] 杨丽英[2] 刘金玲 

机构地区：[1]湛江奥理德眼科医院,广东省湛江市524043 [2]解放军第一八零医院眼科医院,福建省泉州市362008

出　　处：《眼科新进展》2011年第6期547-549,共3页Recent Advances in Ophthalmology

摘　　要：目的研究小梁切除术后视盘的形态学变化,探讨眼压降低导致这种改变的临床意义。方法对19例(20眼)原发性青光眼患者行小梁切除术。采用海德堡视网膜断层扫描仪II型(HRT-Ⅱ)分析视盘的形态学改变,并检查视力、眼压、滤过泡、渗漏、前房深度等情况。结果术前及术后1周眼压分别为(36.83±14.10)mmHg(1kPa=7.5mmHg)和(12.00±5.05)mmHg,二者比较差异有显著统计学意义(P=0.000);术前及术后1周,杯盘面积比分别为0.666±0.212和0.574±0.236(P=0.001),术后明显缩小,缩小百分比为13.81%;与术前相比,术后1周盘沿面积和盘沿容积显著增大(均为P=0.001),分别增大了26.18%和47.93%;视杯形态测量值、视杯高度变异轮廓值、视网膜神经纤维层厚度与术前比较差异均无统计学意义(均为P>0.05)。眼压变化与上述参数变化无明显相关性(均为P>0.05)。结论眼压的大幅度下降可能是导致杯盘面积比变小、盘沿面积及容积增大的重要原因之一,而视网膜神经纤维层厚度尚未发生明显改变,视神经纤维可能未继续受到损害。Objective To investigate the clinical significance of intraocular pressure decrease inducing morphological changes of optic disc after trabeculectomy.MethodsTrabeculectomy was taken in 19 cases（20 eyes）with primary glaucoma.The morphological changes of the optic disc were evaluated with Heidelberg retina topography Ⅱ（HRT-Ⅱ）.ResultsThe IOP values were（36.83±14.10）mmHg（1 kPa=7.5 mmHg）and（12.00±5.05）mmHg at pre-operation and postoperative 1 week,respectively,the postoperative IOP values significantly reduced（P=0.000）.The cup/disk area ratios were 0.666±0.212 and 0.574±0.236 at pre-operation and postoperative 1 week（P=0.001）.The postoperative cup/disk area ratio significantly decreased with reduction of 13.81%.compared with those at pre-operation,rim area and volume significantly increased by 26.18% and 47.93% at postoperative 1 week,respectively（P=0.001）.However,no significant difference was observed in the cup shape measure,height variation contour and mean retinal nerve fiber layer thickness（all P0.05）.ConclusionsSubstantial reduction in IOP may be one of the important reasons causing a reduction in the size of optic cup and an increase in the rim area and volume.On the other hand,no significant change is observed in retinal nerve fiber layer thickness,which indicates that no sustained damage is occurred in optic nerve fibers.

关 键 词：HRT-Ⅱ 小梁切除术 视盘 青光眼 

分 类 号：R776.2[医药卫生—眼科]