晶状体悬韧带异常继发闭角型青光眼生物学测量参数特征分析  

Analysis of biometric characteristics of angle-closure glaucoma caused by abnormal suspensory ligament

作　　者：梁雪梅[1] 王瑛 李凌 李莉[1] Liang Xuemei;Wang Ying;Li Ling;Li Li(Department of Glaucoma,Nanning Aier Eye Hospital,Nanning 530012,China)

机构地区：[1]南宁爱尔眼科医院青光眼科,南宁530012

出　　处：《中华眼外伤职业眼病杂志》2023年第5期328-335,共8页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：爱尔眼科医院集团临床研究所科研基金资助(AR2002D9)。

摘　　要：目的分析术前及术中发现晶状体悬韧带异常继发的闭角型青光眼(SACG-ASL)的眼前节生物特征。方法回顾性病例对照研究。选取南宁爱尔眼科医院2020年1月至2022年10月SACG-ASL36例(38只眼)作为观察组;另选原发性闭角型青光眼(PACG)69例(69只眼)作为对照组。所有患者手术前常规进行超声生物显微镜(UBM)及IOL Master 700检查,测量眼压、眼轴、晶状体矢高、前房深度、晶状体厚度,并计算双眼前房深度差异,分析比较两组眼前节生物测量参数的特征。结果观察组眼压25.35(14.83,46.08)mmHg低于对照组38.0(25.65,51.85)mmHg(1 mmHg=0.133 kPa)(Z=-2.37,P=0.018),前房深度(1.65±0.35)mm小于对照组(1.85±0.23)mm(t=-3.61,P<0.001),晶状体矢高(1.16±0.44)mm高于对照组(0.80±0.22)mm(t=5.68,P<0.001),晶状体厚度5.16(4.83,5.61)mm大于对照组4.89(4.72,5.24)mm(Z=-3.36,P=0.001),双眼前房深度差异0.30(0.06,0.69)mm大于对照组0.10(0.05,0.22)mm(Z=-2.31,P=0.021)。个体两眼间的比较,SACG-ASL组患眼前房深度比对侧眼明显变浅(t=2.98,P=0.004),晶状体矢高比对侧眼明显增高(t=-2.26,P=0.027)。多因素二元logistic回归分析显示晶状体矢高(OR=164.12,P<0.001)及双眼前房深度差异(OR=2.37,P=0.032)与SACG-ASL有显著正相关性。晶状体矢高值的受试者工作曲线下面积是0.805,在1.06 mm是晶状体悬韧带异常和正常的最佳分界点。双眼前房深度差异的曲线下面积是0.665,在0.29 mm处是最佳分界点。结论术前晶状体矢高大于1.06 mm,双眼前房深度差异大于0.29 mm,应考虑晶状体悬韧带异常的可能。Objective To summarize the biometric measurement parameters of anterior segment in patients with secondary angle closure glaucoma associated with abnormality suspension ligament(SACG-ASL)before and during operation.Methods This was a retrospective case control study.Clinical data of SACG-ASL patients from Jan.2020 to Oct.2022 in Nanning Aier Eye Hospital were selected as the observation group(38 eyes of 36 patients),and primary angle closure glaucoma patients(PACG)were selected as the control group(69 eyes of 69 patients).The intraocular pressure,axial length,anterior chamber depth,lens vault,lens thickness were measured by ultrasound biomicroscopy(UBM)and IOL Master 700 and compared between the 2 groups.In addition,the anterior chamber depth difference was calculated and the characteristics of biometric parameters in the anterior segment were anlayzed and compared.Results The intraocular pressure in the observation group was 25.35(14.83,46.08)mmHg,which was significantly lower than the 38.0(25.65,51.85)mmHg in the control group(1 mmHg=0.133 kPa)(Z=-2.37,P=0.018);the anterior chamber depth was(1.65±0.35)mm,which was shallower than the(1.85±0.23)mm of the control group(t=-3.61,P<0.001);the lens vault was(1.16±0.44)mm,which was higher than the(0.80±0.22)mm of the control group(t=5.68,P<0.001);the lens thickness was 5.16(4.83,5.61)mm,which was thicker than the 4.89(4.72,5.24)mm of the control group(Z=-3.36,P=0.001).Moreover,difference of anterior chamber depth in the observation group was 0.30(0.06,0.69)mm,which was larger than the 0.10(0.05,0.22)mm of the control group(Z=-2.31,P=0.021).Furthermore,affected eyes from the observation group experienced shallower anterior chamber depth(t=2.98,P=0.004)and higher lens vault(t=-2.26,P=0.027)than their matched unaffected eyes.Only the lens vault(OR=164.12,P<0.001)and difference of anterior chamber depth(OR=2.37,P=0.032)remained significant in the multi-variable binary logistic regression.Additionally,according to the receiver operator characteristic curve analysis,both

关 键 词：青光眼 闭角型 晶状体悬韧带 深度 前房 矢高 晶状体 

分 类 号：R775[医药卫生—眼科]