滤过术后原发性慢性闭角型青光眼角膜滞后量的改变  

The change of corneal hysteresis after trabeculectomy in chronic primary angle closure glaucoma

作　　者：李秀红[1] 王玉宏[1] 段素芳[2] 方爱武[1] 潘伟华[1] 

机构地区：[1]温州医学院附属眼视光医院青光眼专科,325027 [2]新乡医学院第三附属医院眼科

出　　处：《中国实用眼科杂志》2013年第3期273-277,共5页Chinese Journal of Practical Ophthalmology

基　　金：温州市科技计划项目（20090130）

摘　　要：目的探讨原发性慢性闭角型青光眼（CPACG）患者小梁切除术后角膜滞后量的动态改变。方法前瞻性临床对照研究。50例一眼发病的CPACG患者行小梁切除术，降眼压治疗前及术后10d、1、2、3月用眼反应分析仪测量角膜滞后量（CH）及Goldmann相关眼压（IOPg）；超声角膜测厚仪测量中央角膜厚度（CCT）。术后每次随访IOPg均〈21mmHg者才纳入统计。选取年龄、性别比例相近的50例正常人，与CPACG眼的对侧眼作为对照。结果最终纳入统计的CPACG患者49例。CPACG眼术前IOPg（35．72±12．5）mmHg明显高于对侧眼（12．39±4．22）mmHg及正常组（12．09±3．55）mmHg（P〈0．01）；术后各时间点IOPg较术前明显降低（P〈0．01），与对侧眼和正常眼相比，差异无统计学意义（P〉0．05）。CPACG眼术前CH值（6．84±2．11）mmHg明显低于对侧眼（10．57±1．39）mmHg和正常眼（10．72±1．29）mmHg，差异有统计学意义（P〈0．01）；术后CH值逐渐升高，3个月时（10．16＋1．64）mmHg与对侧眼及正常组相比无统计学意义P〉0．05）。CPACG眼CCT术前及术后各时间点与对侧眼及正常眼之间无统计学意义（P〉0．05）；CPACG眼各时间点CCT之间也无统计学意义（P〉0．05）。CPACG眼术前IOPg与CH显著负相关（r=-0．738，P〈0．01），术后两者无明显相关性（P〉0．05）；手术前后IOPg的降低值与CH的升高幅度显著正相关（P〈0．01）。CPACG眼术前CH与CCT无相关性（P〉0．05），术后则呈显著正相关（P〈0．01）。结论CPACG眼的CH值较对侧眼和正常眼低，滤过术后眼压成功降低，CH逐渐恢复，3个月时与其它两组差异无统计学意义。ObJective To detect the dynamic changes of the corneal hysteresis after trabeculectomy in chronic primary angle closure glaucoma （CPACG）. Methods Prospective clinic control study. Fifty patients with one eye diagnosed as CPACG were included. Corneal hysteresis （CH） and Goldmann correlated intraocular pressure （IOPg） were obtained with ocular response analyzer （ORA） before and 10 days, 1 month, 2 and 3 months after trabeculectomy. Central corneal thickness （CCT） was also examined using ultrasound A. The fellow eyes and 50 eyes of 50 normal patients were as control. CPACG eyes with IOPg less than 21 mmHg each follow-up were finally included. Results Forty nine CPACG patients were finally included. IOPg decreased significantly from （35.72±12.5） mmHg before trabeculectomy to （11.46±4.29） mmHg, and CH increased significantly from （6.84± 2.11） mmHg to （10.16±1.63） mmHg at 3 months. The CH in the treated eyes had no statistic difference at 3 months compared with that of fellow and normal eyes （P 〉0.05）. Before treatment, CH was negatively correlated with IOPg （r =-0.74, P 〈0.05; however, no correlation was found after surgery. The increased value of CH was correlated with the decreased value of IOPg. The CH had no correlated with CCT before treatment; however there was correlation after surgery. Conclusions CH is significantly lower in CPACG eyes, and completely recovered 3 months after successful trabeculectomy.

关 键 词：原发性慢性闭角型青光眼 角膜滞后量 中央角膜厚度 眼压 

分 类 号：R775[医药卫生—眼科]