白内障超声乳化摘出术后OCT测量的眼前节结构改变  

The changes of ocular anterior segment configuration following phacoemulsification determined by anterior segment OCT

作　　者：郑虔[1] 李瑾[1] 赵云娥[1] 

机构地区：[1]温州医科大学附属眼视光医院,310020

出　　处：《中华实验眼科杂志》2016年第6期566-570,共5页Chinese Journal Of Experimental Ophthalmology

摘　　要：目前,白内障是世界上主要的致盲眼病,其次是青光眼.年龄相关性白内障未成熟期晶状体膨胀,构成闭角性青光眼发生的危险因素,及早进行白内障超声乳化摘出术是解决该危险因素的最佳手段.选择何时进行手术以及预后效果成为困扰临床医师的问题.本研究纳入17篇应用眼前节OCT（AS-OCT）分别对白内障超声乳化摘出术前后眼前节生物测量不同参数进行定量分析的文献,就白内障超声乳化摘出术对眼前节结构的影响进行综合评价.全部文献累计866患眼;随访时间为术后6个月.术后前房深度（ACD）、前房容积（ACV）、前房角度（ACA）、巩膜突起500 μm房角开放距离（AOD500）、AOD750、巩膜突起500 μm小梁与虹膜接触面积（TISA500）、TISA750、巩膜突起750μm房角隐窝面积（ARA750）均较术前不同程度升高,术后前房宽度（ACW）、巩膜突起750.μm处的虹膜厚度（IT750）均无明显变化,术后虹膜弯曲度（I-Curv）、虹膜横断面面积、虹膜突面积较术前降低.术前LT与术后ACD及术后TISA500均呈高度正相关.术前晶状体拱高（LV）与术后3个月ACD及术后3个月AOD500均呈正相关.综合文献证实,白内障超声乳化摘出术可解除瞳孔阻滞,减小虹膜压迫,使得前房加深和房角增宽.白内障超声乳化摘出联合人工晶状体植入术可用于青光眼的治疗,值得进一步推广.Cataract is a main blinding eye disease worldwide,follwed by glaucoma.Expension of lens volume occurs in early stage of age-related cataractous eyes,which is a risk factor of Primary angle-closure glaucoma,and phacoemulsification is a feasible approach to remove it.However,how to select the timing of operation and determine the prognosis is the major challenge for ophthalmologists.In order to evaluate the influence of phacoemulsification on ocular anterior segment configuration,we collected the information of 17 articles that quantitatively analyzed the ocular anterior segment parameter changes after phacoemulsification,determined by anterior segment OCT （AS-OCT）.Total 866 eyes that received phacoemulsification for age-related cataract were included in the following-up duration for 6 months,and the results showed that the mean anterior chamber depth （ACD）,anterior chamber volume （ACV）,anterior chamber angle （ACA）,angle opening distance 500 μm anterior to the scleral spur （AODS00）,angle opening distance 750 μm anterior to the scleral spur （AOD750）,trabecular-iris space area 500 μm from scleral spur （TISA500）,trabecular-iris space area 750 μm from scleral spur（TISA750）,and angle recess area 750 μm anterior to the scleral spur （ARA 750） were increased,but the mean anterior chamber width （ACW） and iris thickness measured at 750 μm （IT750） were not significantly changed,while the postoperative iris curvature （I-Curv）,iris cross-sectional area and convex hull of iris segments were decreased after phacoemulsification.In addition,the postoperative ACD,TISA500 showed positive correlations to preoperative lens thickness,and the ACD and AOD500 in 3 months after operation were positively correlated to the preoperative lens value （LV）.This systematic review concluded that phacoemulsification could be used for the treatment of glaucoma by relieving pupillary block,reducing the iris oppression,deepening the anterior chamber and opening anterior chamber angle.

关 键 词：白内障/并发症 白内障超声乳化摘出术 术后并发症 闭角型青光眼/生理病理 X线断层摄影术 光学相干 眼前节 系统评价 

分 类 号：R779.66[医药卫生—眼科]