白内障手术中发现悬韧带异常的原发性闭角型青光眼患者的眼生物测量特征分析  

Biometric characteristics of primary angle closure glaucoma with zonular abnormality found during cataract surgery

作　　者：裴雪婷 范志刚 卿国平 李栋军 王书华 Pei Xueting;Fan Zhigang;Qing Guoping;Li Dongjun;Wang Shuhua(Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Key Laboratory of Ophthalmology and Visual Science,Beijing 100730,China)

机构地区：[1]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

出　　处：《眼科》2021年第4期264-269,共6页Ophthalmology in China

摘　　要：目的探讨原发性闭角型青光眼(primary angle closure glaucoma,PACG)白内障手术中发现晶状体悬韧带异常患者的生物学测量参数特征。设计回顾性比较性病例系列。研究对象2019年5月至2020年12月北京同仁医院连续的PACG术前未明确悬韧带异常、白内障术中发现悬韧带异常者(术中悬韧带异常组)45例(45眼),PACG悬韧带无异常者95例(95眼),术前即诊断为晶状体不全脱位继发闭角型青光眼者41例(41眼),共181例181眼。方法回顾三组患者的病例资料。比较三组患者的IOLmaster和UBM的生物学测量参数。主要指标前房深度、晶状体拱高、晶状体厚度、眼轴长。结果术中悬韧带异常组和悬韧带无异常组的前房深度[(1.61±0.31)mm、(1.74±0.35)mm,P=0.074]和眼轴长[(22.07±0.78)mm、(22.20±0.75)mm,P=0.650]无统计学差异。晶状体拱高在术中悬韧带异常组、悬韧带无异常组和晶状体不全脱位组分别为[(1.41±0.35)、(1.04±0.21)、(1.73±0.45)mm,P=0.000];两两比较中差异均有统计学意义。术中悬韧带异常眼的晶状体拱高[(1.42±0.25)mm]、高于对侧健眼[(1.24±0.27)mm](P=0.049)。晶状体厚度在术中悬韧带异常组和晶状体不全脱位组[(5.14±0.26)、(5.18±0.29)mm,P=0.808]中无统计学差异,但较悬韧带无异常组[(4.89±0.31)mm,P=0.001]增厚。术中悬韧带异常组患者80%晶状体拱高>1.2 mm,晶状体厚度>4.9 mm。结论PACG患者白内障手术前晶状体拱高超过1.2 mm同时晶状体厚度超过4.9 mm时应警惕晶状体悬韧带异常的可能。(眼科,2021,30:264-269)Objective To observe the characteristics of ocular parameters in primary angle closure glaucoma(PACG)combined cataract patients with zonular abnormality found during cataract surgery.Design Retrospective comparative case series.Participants Patients with PACG who underwent cataract surgery from May,2019 to December,2020 at Beijing Tongren Hospital were reviewed,which include 45 PACG eyes with zonular abnormality found during cataract surgery(zonular abnormality group),95 PACG eyes without zonular abnormality,and 41 eyes with secondary angle closure glaucoma induced by lens subluxation(SACG-LS).Methods Medical records of all patients were reviewed,including ocular parameters measured using IOL master and UBM.Main Outcome Measures Anterior chamber depth(ACD),lens vault(LV),lens thickness(LT),and axial length(AL).Results There was no statistically significant difference in AL[(22.07±0.78)mm vs(22.20±0.75)mm,P=0.650]and ACD[(1.61±0.31)mm vs(1.74±0.35)mm,P=0.074]between zonular abnormality group and without zonular abnormality group.LV was 1.41±0.35 mm in zonular abnormality group,1.04±0.21 mm in without zonular abnormality group,and 1.73±0.45 mm in SACG-LS group.The LV differences between every two groups reached statistical significance(all P=0.000).The LV inter-eye difference reached statistical significance[(1.42±0.25)mm vs(1.24±0.27)mm,P=0.049]in zonular abnormality group.LT showed no statistical significance between zonular abnormality group and SACG-LS group[(5.14±0.26)mm vs(5.18±0.29)mm,P=0.808],and thicker than without zonular abnormality group.80%patients of zonular abnormality group showed LV higher than 1.2 mm as well as LT thicker than 4.9 mm.Conclusion It is probability that the zonule may be abnormal in PACG patients with preoperative LV higher than 1.2 mm as well as LT thicker than 4.9 mm.

关 键 词：原发性闭角型青光眼 悬韧带 晶状体拱高 晶状体厚度 

分 类 号：R779.6[医药卫生—眼科]