原发性急性闭角型青光眼合并白内障患者超声乳化术后眼前节的变化  

Evaluation of biological measurement of ocular anterior segment after phacoemulsification in acute primary angle-closure glaucoma with cataract

作　　者：曾招荣[1] 李彬斌[2] 招志毅[1] 戴静[1] 王海梅[1] 

机构地区：[1]广西医科大学第四附属医院,柳州市工人医院眼科,广西壮族自治区柳州市545005 [2]暨南大学第一附属医院保健科,广东省广州市510632

出　　处：《眼科新进展》2014年第11期1077-1081,共5页Recent Advances in Ophthalmology

摘　　要：目的采用超声生物显微镜(ultrasound biomicroscope,UBM)和眼前节光学相干断层扫描仪(optical coherence tomography,OCT)2种检测方法观察原发性急性闭角型青光眼合并白内障患者行超声乳化手术前后的眼前节解剖结构变化,评估这2种检查方法的应用价值。方法对35例35眼原发性急性闭角型青光眼合并白内障患者行超声乳化白内障摘出联合人工晶状体植入术,监测术前及术后最佳矫正视力(best corrected visual acuity,BVCA)及眼压,于术前、术后3个月分别用UBM及Visante OCT对眼前节进行生物学测量,分析术前术后眼前节参数的变化,并比较2种检测方法的差异。结果所有患者术后1周、1个月、3个月眼压分别为(13.85±5.06)mmHg(1 kPa=7.5 mmHg)、(13.29±4.55)mmHg、(13.47±4.11)mmHg,与术前((17.07±4.02)mmHg相比均显著降低并保持平稳,术后1周、1个月、3个月BCVA分别为0.51±0.10、0.65±0.21、0.63±0.19,与术前(0.20±0.10)相比均显著提高。眼压和BCVA术前、术后的差异均有统计学意义(F=9.33,P=0.000;F=106.27,P=0.000)。UBM和Visante OCT术后检测中央前房深度(anterior chamber depth,ACD)分别为(3.41±0.44)mm、(3.45±0.39)mm,与术前分别为(1.93±0.28)mm、(1.95±0.32)mm相比明显加深,差异具有统计学意义(t=-12.142,t=-12.087,均为P=0.000),2种检测方法之间相比差异无统计学意义(t=0.143,P=0.890;t=-0.197,P=0.824)。UBM和Visante OCT检测术后房角开放距离AOD500分别为(0.37±0.16)mm、(0.29±0.11)mm,与术前分别为(0.18±0.10)mm、(0.15±0.05)mm相比显著增加,差异具有统计学意义(t=-14.561,t=-13.233,均为P=0.000),2种检测方法之间相比差异具有统计学意义(t=1.825,P=0.046;t=-4.054,P=0.000)。UBM和Visante OCT术后检测小梁虹膜夹角分别为(36.55±5.93)°、(29.83±4.87)°,与术前分别为(17.81±5.17)°、(12.44±4.25)°相比显著增加,差异具有统计学意义(t=-13.328,t=-11.751,均为P=0.000),2种检测方法之间相比差异具有统计学意义(Objective To observe the changes in the anatomical structure of the ocular anterior segment in patients with acute primary angle-closure glaucoma combined with cataract before and after phacoemulsification using ultrasound biomicroscope（ UBM） and anterior segment optical coherence tomography（ OCT）,and evaluate the clinical application value of these two measuring systems. Methods Thirty-five eyes of 35 patients with APACG combined with cataract received phacoemulsification with intraocular lens implantation. Best corrected visual acuity（ BVCA） and intraocular pressure were recorded pre-and post-operatively. The changes of ocular anterior segment parameters before and three months after surgery were analyzed using UBM and Visante OCT. The difference was compared between these two measuring systems. Results The intraocular pressure of all patients were（ 13. 85 ± 5. 06） mmHg（ 1 kPa = 7. 5 mmHg）,（ 13. 29 ± 4. 55）mmHg,（ 13. 47 ± 4. 11） mmHg at 1 week,1 month,3 months postoperatively,which was significantly decreased to a stable low level compared with that preoperatively（ 17. 07 ± 4. 02） mmHg.BCVA were 0. 51 ± 0. 1,0. 65 ± 0. 21 and 0. 63 ± 0. 19 at 1 week,1 month,3 months postoperatively,respectively,which were significantly improved than preoperatively 0. 20 ± 0. 10. The difference of intraocular pressure and BCVA between before and after surgery were statistically significant（ F = 9. 33,P = 0. 000; F = 106. 27,P = 0. 000）. The central anterior chamber depth postoperatively detected by UBM and Visante OCT were（ 3. 41 ± 0. 44） mm and（ 3. 45 ± 0. 39）mm,respectively,which were significantly increased compared with that preoperatively（ 1. 93 ± 0.28） mm and（ 1. 95 ± 0. 32） mm,the difference was statistically significant（ t =- 12. 142,- 12.087,all P = 0. 000）,and statistical difference was not detected between the two measuring systems（ t = 0. 143,P = 0. 890; t =- 0. 197,P= 0. 824）. The angle opening distance postoperatively detected by UBM and Visant

关 键 词：超声生物显微镜 眼前节相干断层扫描仪 青光眼 白内障 

分 类 号：R779.6[医药卫生—眼科]