人工晶状体植入术后房角与眼压变化之间的相关性研究  

Correlation of the anterior chamber angle and intraocular pressure changes after intraocular lens implantation

作　　者：刘玉青[1] 刘玉霞[2] 戴冬姝[1] 冀向宁[1] 王静娴[1] 邹媛媛[1] 李坤[1] 王志学[1] 侯四清[1] 叶存喜[3] 

机构地区：[1]河北省沧州市中心医院眼二科,050005 [2]河北省沧州市中心医院超声科,050005 [3]河北医科大学附属第二医院眼科

出　　处：《临床眼科杂志》2011年第5期388-392,共5页Journal of Clinical Ophthalmology

摘　　要：目的研究人工晶状体植入术后前房角宽度及眼压变化情况之间的相关性。方法随机选取120例(137只眼)老年性白内障患者,于表麻下行透明角膜切口超声乳化白内障摘除人工晶状体植入术,保留手术过程顺利、后囊膜完整、人工晶状体植入囊袋中的病例作为研究对象。术前用超声生物显微镜(UBM)测量房角相关参数:房角开放距离(AOD500)、小梁虹膜夹角(TIA)、前房深度(ACD);用Goldmann眼压计测量眼压。分别于术后2周、1个月、3个月再用UBM及Goldmann眼压计复查如上参数;术前以前房角镜观察并记录房角形态并于术后1个月复查房角形态。结果术前所测量的眼压与正常眼前节数据有显著性差异;术前所测量的ACD、AOD、TIA、眼压分别与术后2周、1个月、3个月复查数据进行多样本均数间的多重比较,均为P<0.05,均有显著性差异;术后2周、1个月、3个月时,AOD及眼压改变的量之间存在负相关;TIA夹角及眼压改变的量之间存在负相关。结论 (1)研究对象的ACD、AOD、TIA与正常眼前节相关数据比较,无显著性差异;但是,眼压较正常值稍高,提示部分患者有发生闭角型青光眼的潜在趋势。(2)超声乳化白内障摘除人工晶状体植入术后,前房深度及房角宽度显著增大,眼压显著降低,避免或减少了闭角型青光眼的发生机会。(3)AOD、TIA这2个变量与眼压这个变量间呈负相关。提示在老年人群中,AOD、TIA是影响眼压的重要因素。Objective To study the correlation of anterior chamber angle and intraocular pressure changes after intraocular lens implantation.Methods 120 patients with cataract were randomly selected,anesthesized,and underwent phacoemulsification cataract extraction and intraocular lens implantation.The surgery went smoothly,the posterior capsule was intact,and intraocular lens was implanted in the capsular bag.Preoperative and postoperative measurement of UBM,angle parameters： AOD500,TIA,ACD,and the Goldmann tonometer IOP were reviewed.2 weeks,1 month,3 months after surgery,UBM,Goldmann tonometer,and all above parameters were re-analyzed.Preoperative and 1-month postoperative gonioscopy were observed.Results There was a significant difference of intraocular pressure,anterior chamber depth,angle opening distance,trabecular iris angle,intraocular pressure between preoperative and postoperative measurements at 2 weeks,1 month and 3 month（P〈0.05）.The angle opening distance and intraocular pressure was negatively correlated,trabecular iris angle and intraocular pressure changes was negatively correlated.Conclusion（1）There is no no significant difference of anterior chamber depth,angle opening distance,trabecular iris angle of the anterior segment associated;However,the intraocular pressure is higher than normal,suggesting that some patients with angle-closure has a potential to develop glaucoma.（2）After phacoemulsification cataract extraction with intraocular lens implantation,anterior chamber depth and angle width is significantly increased,intraocular pressure is decreased significantly,to avoid or reduce the incidence of angle-closure glaucoma.3.angle opening distance and trabecular iris angle are negatively correlated with intraocular pressure,demonstrated that in the elderly population,the angle opening distance,trabecular iris angle are important factors affecting the intraocular pressure.

关 键 词：人工晶状体 房角 眼压 白内障 超声生物显微镜 

分 类 号：R779.6[医药卫生—眼科]