巩膜外环扎术对孔源性视网膜脱离患者眼前节解剖结构的影响  

Effect of scleral encircling on the anatomical structure of the anterior segment in patients with rhegmatogenous retinal detachment

作　　者：霍亚丹 金波[1] 金学民[1] Huo Yadan;Jin Bo;Jin Xuemin(Department of Ophthalmology,the First Affiliated Hospital of Zhengzhou University,Henan Provincial Ophthalmic Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院河南省眼科医院,郑州450052

出　　处：《中华眼外伤职业眼病杂志》2023年第4期255-260,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：河南省高等学校重点科研项目(23A320067)。

摘　　要：目的观察巩膜外环扎术对孔源性视网膜脱离(RRD)患者眼前节解剖结构的影响。方法回顾性病例系例研究。纳入郑州大学第一附属医院眼科2021年5月至2022年10月住院行巩膜外环扎术治疗者RRD 32例(32只眼)。所有患者应用扫频源光学相干断层扫描(SS-OCT)测量术前、术后24 h及3~5个月的眼前节解剖学参数,同时测量眼的屈光状态以SE表示、视力(BCVA)及眼轴长度。结果手术后24 h:等效球镜度(-6.38±2.81)D较术前(-4.29±2.27)D负值增加,差异有统计学意义(P<0.001);眼轴(26.67±1.21)mm较术前(24.85±1.11)mm增加,差异有统计学意义(P<0.001);眼前节解剖参数:晶状体厚度(3.92±0.33)mm及中央角膜厚度(0.57±0.03)mm分别较术前(3.68±0.31)mm,(0.54±0.03)mm增厚,差异均有统计学意义(均P<0.001);晶状体位置(4.86±0.38)mm较术前(5.04±0.34)mm前移,差异有统计学意义(P<0.001);前房深度(2.72±0.41)mm低于术前(3.17±0.34)mm,差异有统计学意义(P<0.001);前房角开放距离(AOD500)及小梁虹膜夹角(TIA500)均较术前减小,差异有统计学意义(均P<0.001)。术后3~5个月,眼屈光状态(-6.17±2.21)D较术前负值增加,眼轴长度(26.87±1.23)mm较术前增加,差异均有统计学意义(均P<0.05);晶状体厚度(3.61±0.29)mm较术前厚,差异有统计学意义(P=0.012);余眼前节解剖参数与术前相比,差异均无统计学意义(均P>0.05)。术后3~5个月所有眼前节参数与对侧健康眼比较,差异均无统计学意义(均P>0.05)。结论巩膜外环扎术治疗RRD安全且有效,术后晚期观察到晶状体厚度轻度增加但这种变化不足以影响前房角的功能。Objective To observe the effect of scleral encircling surgery on the anterior segment parameters in patients with rhegmatogenous retinal detachment(RRD).Methods This was a retrospective case series study.A total of 32 eyes of 32 patients with unilateral RRD who underwent scleral encircling surgery in the First Affiliated Hospital of Zhengzhou University from May 2021 to Oct.2022 were included.Anterior segment anatomical parameters of all patients were measured by swept source optical coherence tomography(SS-OCT)before surgery,at 24 h and 3-5 months after surgery.And the refractive status represented by SE,visual acuity(BCVA)and axial length were measured.Results At 24 h after surgery,the negative value of spherical equivalent(-6.38±2.81)D was significantly higher than the(-4.29±2.27)D before surgery(P<0.001).Compared with the(24.85±1.11)mm before surgery,the axial length(26.67±1.21)mm significantly increased(P<0.001).Anterior segment anatomical parameters:lens thickness(3.92±0.33)mm and central corneal thickness(0.57±0.03)mm were thicker than those before surgery[(3.68±0.31)mm and(0.54±0.03)mm],respectively,and the differences were statistically significant(all P<0.001).Compared with the preoperative(5.04±0.34)mm,the lens position(4.86±0.38)mm significantly moved forward(P<0.001).The anterior chamber depth(2.72±0.41)mm was significantly lower than the(3.17±0.34)mm before surgery(P<0.001).The anterior chamber angle opening distance(AOD500)and trabecular iris angle(TIA500)were significantly lower than those before surgery(all P<0.001).In 3-5 months after surgery,the negative value of refractive state(-6.17±2.21)D and the axial length(26.87±1.23)mm statistically increased compared with those before surgery(all P<0.05).The lens thickness(3.61±0.29)mm was significantly thicker than that before surgery(P=0.012).There was no significant difference in the anatomical parameters of the anterior segment between before and after surgery(all P>0.05).There were no statistically significant differences in all ant

关 键 词：视网膜脱离 巩膜扣带术 视敏度 眼前半段 

分 类 号：R779.6[医药卫生—眼科]