可疑原发性房角关闭患者激光周边虹膜切开术后远期房角生物测量分析  

Long-term outcomes of ultrasound biomicroscopy in eyes with primary angle closure suspect after laser peripheral iridotomy:a five-year progression study

作　　者：吕爱国[1,2] 牟大鹏[3] 郭黎霞[2] 梁远波[4] 李思珍[5] 崔宏宇[2] 张志宏[2] 范肃洁[2] 

机构地区：[1]河北省承德医学院研究生院,067000 [2]河北省邯郸市眼科医院(邯郸市第三医院),056001 [3]首都医科大学附属北京同仁医院,北京同仁眼科中心,眼科学与视觉科学北京市重点实验室,100730 [4]温州医科大学附属眼视光医院,325027 [5]南京爱尔眼科医院,210006

出　　处：《眼科》2016年第1期23-28,共6页Ophthalmology in China

基　　金：河北省科技攻关项目(06276102D-61)

摘　　要：目的通过超声生物显微镜(UBM)测量分析评价可疑原发性房角关闭(PACS)患者激光周边虹膜切开术(LPI)后5年的房角生物形态学变化。设计前瞻性病例对照研究。研究对象河北省邯郸市眼科医院连续的PACS患者42例。方法每例患者随机选取一眼行LPI治疗。LPI术前及术后5年时进行眼科常规检查及UBM检查。主要指标UBM图像巩膜突前500μm和750μm处的房角开放距离(AOD)、小梁虹膜夹角(TIA)、房角隐窝面积(ARA)、小梁睫状体距离(TCPD)、虹膜厚度(IT)等参数。结果42例患者平均随访(5.2±0.5)年。LPI术后5年时AOD500、AOD750、TIA500、TIA750、ARA500及ARA750较术前均明显增加(P均<0.001),TCPD500与TCPD750在术后5年分别增加了5%和10%(P均<0.05),IT500、IT750分别较术前减少11%和6%(P均<0.05),750μm处的参数变化较500μm处更明显。LPI术后,激光干预眼的上方房角变化幅度最大,颞侧的变化幅度最小,且巩膜突750μm处的参数的增幅均较巩膜突500μm处的参数增幅大。与对侧眼相比,除IT750与IT500以外,激光术后5年的各项参数的测量值均明显增加(P均<0.05)。结论 LPI可增宽PACS患眼的前房角,并具有较好的远期效果。Objective To quantitatively evaluate the long-term changes in anterior segment morphology with ultrasound biomieroscopy （UBM） after laser peripheral iridotomy （LPI） in eyes with primary angle closure suspect （PACS）. Design Prospective case series study. Participants 42 PACS consecutive patients in Handan Eye Hospital, Hebei were enrolled. Method LPI was performed in one eye selected randomly for every PACS. Routine ophthalmic tests and UBM examination were performed at presentation and 5 years after LPI. Main Outcome Measures The parameters of anterior chamber angle ahead 500 μm and 750 μm of seleral spur, such as angle opening distance （AOD）, trabeeular-iris angle （TIA）, angle recess area （ARA） trabecular-ciliary process distance （TCPD） and iris thickness （IT） on UBM images. Results The mean follow-up period was （5.2±0.5） years in 42 patients. AOD500, AOD750, TIA500, TIA750, ARA500, and ARA750 were significantly widen at 5 years after LPI than that at presentation in eyes with PACS （all P〈0.001）. IT500, IT750 were significantly decreased 11% and 6% respectively at 5 years after LPI than that at presentation in eyes with PACS （all P〈 0.001）, and the parameters at 750μm anterior to the selera spur were more significantly wide than its 500 μm counterpart. Conclusion LPI can significantly widen the peripheral anterior angle in eyes with PACS and this effectiveness to be sustained at least 5 years after LPI.

关 键 词：可疑原发性房角关闭 激光周边虹膜切开术 超声生物显微镜 

分 类 号：R779.6[医药卫生—眼科]