激光周边虹膜成形术对角膜内皮细胞影响的临床观察  

Comparative evaluation of laser peripheral iridotomy intervention in primary angle-closure suspect curative effect based on Pentacam analysis system and ultrasonic bio microscope(UBM)

作　　者：尹奕[1] 王艳玲[1] 

机构地区：[1]首都医科大学附属北京友谊医院眼科,北京100050

出　　处：《临床和实验医学杂志》2013年第23期1895-1898,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的观察激光周边虹膜成形术对角膜内皮细胞的影响并分析相关影响因素。方法对16例(30眼)高褶虹膜综合征及闭角型青光眼患者行激光周边虹膜成形术。于术前及术后1周应用非接触角膜内皮显微镜进行观察及对比分析,测量指标包括:角膜中央区域内测量的最大细胞面积(MAX)、最小细胞面积(MIN)、平均细胞面积(AVE)、细胞面积标准差(SD)、变异系数(CV)及细胞密度(CD)。结果手术前后比较,患者角膜内皮细胞在术后1周时,角膜内皮细胞的丢失率为2.13%±9.57%。角膜内皮细胞密度和平均细胞面积均有变化,差异具有统计学意义(t=2.42,-2.24,P<0.05)。经统计学分析,单次激光能量、激光击射次数、激光总能量与角膜内皮细胞丢失率呈正相关(r=0.59,0.69,0.66;P<0.05)。结论激光周边虹膜成形术可能对角膜内皮细胞造成一定损伤,并损伤与单次激光能量的大小、激光击射次数和激光总能量呈正相关。Objective To explore the application of Pentacam anterior segment measurement analysis system and ultrasonic bio microscope （UBM） quantitative analysis in the primary angle -closure suspect （PACS） patients preoperative and postoperative of laser peripheral iridotomy （LPI） anterior chamber depth （ ACD）, ambits chamber angle （ACA） and anterior chamber volume （ACV） dynamical change. Methods This is a prospective non - randomized controlled clinical study. 33 patients from PACS were included into this study. All these patients received LPI operation using Pentacam and UBM to measure the patients＇anterior segment data of preoperative and postoperative one week. The measuring re- sults were compared in the difference between the two methods. Results （1）Result of Pentacam measurement shows there were no significant change of ACD （ t = -O. 170, P 〉 0. 05 ）, ACA significant change widen （ t = -2. 218, P 〈 0. 05 ）, ACV significant change larger （ t = -4. 879, P 〈 0. 05 ） at postoperative. （2）Result of UBM measurement shows that postoperative were no significant change of ACD （ t = -0. 170, P 〉 0.05 ） , ACA significant change widen （ t = - 2. 218, P 〈0.05 ）. （3） Analysis the ACD and ACA preoperative and postoperative data which were measured by Pentacam and UBM shows that the difference of ACD and ACA have statistic changes （ t = - 7. 050, t = - 15. 038, t = 10.451, t = 2. 274 and all P 〈 0. 05 ）, and ACD were positively correlated, ACA is not relevant. Bland -Altman analysis shows that two methods of measur- ing ACD, ACA have good consistency. Conclusion Pentacam, as a new, noninvasive three dimension eye anterior segment analysis system, can be used in quantitative analysis anterior chamber structure changes of PACS patients LPI preoperative and postoperative. And there are certain differences compared with UBM. And the measure results of ACD and ACA have good consistency, which can play their respective advantages of both instruments to use in the

关 键 词：青光眼 激光周边虹膜成形术角 膜内皮细胞 

分 类 号：R779.63[医药卫生—眼科]