原发性开角型青光眼合并白内障患眼白内障超声乳化吸除手术后视盘血流密度变化  

Changes in peripapillary vessel perfusion in patients with primary open-angle glaucoma after uncomplicated phacoemulsification

作　　者：叶婷 姜惠 王艳[1] 范玮[1] Ye Ting;Jiang Hui;Wang Yan;Fan Wei(Department of Ophthalmology,West China Hospital of Sichuan University,Chengdu 610041,China;Department of Ophthalmology,Chengdu Aier Eye Hospital,Chengdu 610041,China)

机构地区：[1]四川大学华西医院眼科,成都610041 [2]成都爱尔眼科医院,610041

出　　处：《中华眼底病杂志》2021年第6期429-436,共8页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的观察原发性开角型青光眼(POAG)合并白内障患眼白内障超声乳化吸除手术后视盘血流密度(VD)变化。方法病例对照研究。2017年11月至2019年4月于四川大学华西医院眼科检查确诊的POAG并发白内障患者17例17只眼(观察组)、单纯老年性白内障患者17例17只眼(对照组)纳入研究。所有患眼均行最佳矫正视力(BCVA)、眼压、视野、光相干断层扫描血管成像(OCTA)检查以及眼轴长度(AL)、角膜中央厚度(CCT)测量。所有患眼均行常规白内障超声乳化吸除手术。手术后采用与手术前相同的设备和方法行相关检查,观察两组患眼手术前、手术完毕时以及手术后1、7 d和1、3个月VD、视网膜神经纤维层(RNFL)厚度、眼压变化及手术后3个月视野平均缺损(MD)变化。组内数据比较采用重复测量方差分析;组间数据比较采用独立样本t检验。结果观察组、对照组患者平均年龄分别为(68.18±6.13)、(65.82±6.95)岁,差异无统计学意义(t=1.912,P=0.072);患眼AL(t=1.436)、CCT(t=-1.557)、超声乳化时间(t=1.602)比较,差异无统计学意义(P>0.05);平均眼压(t=4.139)比较,差异有统计学意义(P<0.05)。手术前,观察组患眼视盘周围(盘周)VD(t=-6.560)、RNFL厚度(t=-7.320)均低于对照组,差异有统计学意义(P<0.05)。与手术前比较,手术完毕时及手术后不同时间点两组患眼盘周VD均增加。其中,观察组患眼手术后1个月差异有统计学意义(F=3.108,P=0.042);对照组患眼手术后不同时间点差异均无统计学意义(F=1.981,P>0.05)。各象限分析结果显示,仅观察组患眼手术后1个月颞侧差异有统计学意义(F=5.414,P=0.017)。手术后观察组和对照组患眼盘周RNFL厚度均增厚,差异有统计学意义(F=22.670、23.080,P=0.002、0.001)。手术前、手术后3个月,观察组、对照组患眼平均MD分别为(14.90±7.15)、(1.12±0.93)dB和(12.10±7.70)、(0.88±0.66)dB;两组患眼手术前、手术后3个月平均MD比较,差�Objective To observe the changes in peripapillary vessel perfusion after uncomplicated phacoemulsification surgery in patients with cataract and primary open-angle glaucoma(POAG).Methods A case-control study.From November 2017 to April 2019,17 eyes of 17 cases of POAG complicated with cataract(observation group)and 17 eyes of 17 cases of simple senile cataract(control group)were included in the study.All the affected eyes underwent best corrected visual acuity(BCVA),intraocular pressure(IOP),visual field,optical coherence tomography angiography(OCTA)examination,and measurement of axial length(AL)and central corneal thickness(CCT).All eyes underwent conventional phacoemulsification surgery for cataract.After the operation,the same equipment and methods as before the operation were used for related inspections.The VD,the thickness of the retinal nerve fiber layer(RNFL),and the IOP were observed before the operation,at the end of the operation,and 1 d,1 week,1 month and 3 months after the operation,mean visual field defect(MD)changes 3 months after surgery.Data comparisons within groups used repeated measures analysis of variance;data comparisons between groups used independent samples t test.Results The average age of patients in the observation group and control group was 68.18±6.13 and 65.82±6.95 years,respectively,and the difference was not statistically significant(t=1.912,P=0.072).There was no significant difference in AL(t=1.436),CCT(t=-1.557)and phacoemulsification(t=1.602)between the two groups(P>0.05).The difference of the mean IOP was statistically significant between the two groups(t=4.139,P<0.05).Before surgery,the VD(t=-6.560)and RNFL thickness(t=-7.320)of the observation group were lower than those of the control group,and the difference was statistically significant(P<0.05).Compared with before the operation,the VD around the disc of the eye in both groups increased at the end of the operation and at different time points after the operation.Among them,the observation group had a statistically sign

关 键 词：青光眼 开角型 白内障 超声乳化白内障吸除术 视盘周围血流密度 视网膜神经纤维层厚度 

分 类 号：R779.6[医药卫生—眼科]