超声睫状体成形术对青光眼患者眼前节结构的影响及眼前节各参数变化与眼压的关系  

Effects of ultrasound cyclo-plasty on anterior segment structure in glaucoma patients and correlation between anterior segment parameters and intraocular pressure

作　　者：宋婕 王保君[1] 李彦 杨华[1] SONG Jie;WANG Baojun;LI Yan;YANG Hua(Department of Ophthalmology,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453100,Henan Province,China)

机构地区：[1]新乡医学院第一附属医院眼科,河南省新乡市453100

出　　处：《眼科新进展》2023年第10期809-813,共5页Recent Advances in Ophthalmology

摘　　要：目的探讨超声睫状体成形术(UCP)对青光眼患者眼前节结构的影响及眼前节各参数变化与眼压的关系。方法选取2020年3月至2022年5月就诊于新乡医学院第一附属医院眼科行UCP治疗的青光眼患者23例(23眼)作为研究对象。记录患者术前及术后1周、1个月、3个月及6个月的眼压,术前及术后1个月、3个月及6个月行超声生物显微镜检查,记录保存四个方位的图像,记录患者前房深度、瞳孔直径、前房角开放距离(AOD 500)、小梁虹膜夹角(TIA)、巩膜睫状突夹角(SCPA)、睫状体面积(CBA)等眼前节参数,分析各参数的变化量及其与眼压变化的相关性。结果手术前后患者眼压总体比较差异有统计学意义(F=32.039,P<0.01);术后1周[(23.21±5.38)mmHg,1 kPa=7.5 mmHg]、1个月[(24.59±5.64)mmHg]、3个月[(24.63±6.68)mmHg]、6个月[(26.21±6.32)mmHg]患者眼压均较术前[(48.70±6.77)mmHg]明显降低,差异均有统计学意义(均为P<0.05)。术前与术后不同时间患者房角参数(上侧、下侧、颞侧、鼻侧各个方向的AOD 500、TIA)比较差异均无统计学意义(均为P>0.05)。术前与术后不同时间患者上侧和下侧SCPA、CBA比较差异均有统计学意义(均为P<0.01);无论上侧和下侧,术后1个月、3个月、6个月患者SCPA均较术前增大(均为P<0.05),CBA均较术前减小(均为P<0.05)。Pearson相关分析结果显示,术后6个月患者眼压变化量与上侧、下侧的睫状体参数SCPA变化量均存在负相关性(均为P<0.05),与上侧、下侧的睫状体参数CBA变化量均无相关性(均为P>0.05)。结论UCP手术可有效控制青光眼患者眼压,使治疗区域的SCPA增大,CBA减少,且术后6个月患者眼压变化量与上侧、下侧的睫状体参数SCPA变化量呈负相关。Objective To investigate the effects of ultrasound cyclo-plasty(UCP)on the structure of the anterior segment in patients with glaucoma and the correlation between the anterior segment parameters and the intraocular pressure(IOP).Methods A total of 23 patients(23 eyes)with glaucoma undergoing UCP at the Ophthalmology Department of the First Affiliated Hospital of Xinxiang Medical University from March 2020 to May 2022 were enrolled in this study.The IOP before surgery and 1 week,1 month,3 months and 6 months after surgery were recorded.Ultrasound biomicroscopy was performed before surgery and 1 month,3 months and 6 months after surgery.Anterior segment parameters such as anterior chamber depth,pupil diameter,anterior chamber angle opening distance(AOD 500),trabecular iris angle(TIA),scleral ciliary process angle(SCPA),and ciliary body area(CBA)were recorded,and their correlations with the IOP were analyzed.Results There was a significant difference in the IOP before and after surgery(F=32.039,P<0.01).The IOP decreased from preoperative(48.70±6.77)mmHg(1 kPa=7.5 mmHg)to(23.21±5.38)mmHg,(24.59±5.64)mmHg,(24.63±6.68)mmHg and(26.21±6.32)mmHg,respectively,at 1 week,1 month,3 months and 6 months after surgery,and the differences were statistically significant(all P<0.05).There were no significant differences in AOD 500 and TIA in the superior,inferior,temporal and nasal areas before and after surgery(all P>0.05).Significant differences were found in SCPA and CBA in the superior and inferior areas before and after surgery(all P<0.01).Both in the superior and inferior areas,SCPA increased and CBA decreased at 1,3 and 6 months after surgery compared with that before surgery(all P<0.05).Pearson correlation analysis results showed that the changes in the IOP at 6 months after surgery were negatively correlated with the changes in the superior and inferior SCPA(both P<0.05),but had no correlation with the superior and inferior CBA(both P>0.05).Conclusion UCP can effectively control the IOP,increase the SCPA and decrease

关 键 词：超声睫状体成形术 青光眼 眼前节参数 眼压 

分 类 号：R775[医药卫生—眼科]