眼前节光学相干断层扫描在白内障术后角膜后弹力层脱离中的应用  

Application of anterior segment optical coherence tomography in descemet membrane detachment after cataract surgery

作　　者：胡金维 胡淑琼 HU Jinwei;HU Shuqiong(Xi'an Aier Eye Hospital,Xi'an 710000;Jingzhou Aier Eye Hospital,Jingzhou 434000;Jingzhou Hospital of Traditional Chinese Medicine,Jingzhou 434000,China)

机构地区：[1]西安爱尔眼科医院,陕西西安710000 [2]荆州爱尔眼科医院,湖北荆州434000 [3]荆州市中医医院,湖北荆州434000

出　　处：《临床医学研究与实践》2024年第36期62-65,共4页Clinical Research and Practice

基　　金：荆州市科技局市厅级项目(No.2022HC43)。

摘　　要：目的采用眼前节光学相干断层扫描(AS-OCT)观察白内障超声乳化术后角膜后弹力层脱离(DMD)发生位置和范围,对其严重程度进行量化评估,以指导临床治疗。方法回顾性分析2021年2月至2023年5月行白内障超声乳化联合人工晶体植入术后1 d确诊为DMD患者的临床资料,共39眼。通过裂隙灯显微镜观察角膜水肿面积并进行DMD分级;通过AS-OCT测量不同程度DMD的脱离长度、脱离高度、脱离区角膜厚度增加量、脱离区角膜厚度增加比,并分析上述量化指标之间的相关性。结果本研究中,12眼为局限性小脱离,占比30.769%;10眼为轻度脱离,占比25.641%;9眼为中度脱离,占比23.077%;8眼为重度脱离,占比20.513%;本组中无全脱离者。不同程度DMD的脱离长度、脱离高度、脱离区角膜厚度增加量、脱离区角膜厚度增加比比较,差异具有统计学意义(P<0.01)。Pearson相关性分析结果显示,DMD患者的脱离长度、脱离高度、脱离区角膜厚度增加量和脱离区角膜厚度增加比之间具有显著的相关性(P<0.01)。结论AS-OCT可量化评估白内障术后DMD的严重程度,有助于指导其临床诊疗。Objective To observe the location and extent of descemet membrane detachment(DMD)after phacoemulsification by anterior segment optical coherence tomography(AS-OCT),and to quantitatively evaluate its severity,so as to guide clinical treatment.Methods The clinical data of 39 eyes of patients diagnosed with DMD after 1 d of phacoemulsification and intraocular lens implantation from February 2021 to May 2023 were retrospectively analyzed.The corneal edema area was observed by slit lamp microscope and DMD grading was performed;the length of detachment,the height of detachment,the increase of corneal thickness in detachment zone and the increase ratio of corneal thickness in detachment zone among different degrees of DMD were measured by AS-OCT,and the correlation between the above quantitative indicators was analyzed.Results In this study,12 eyes were limited small detachment,accounting for 30.769%;10 eyes were mild detachment,accounting for 25.641%;9 eyes were moderate detachment,accounting for 23.077%;8 eyes were severe detachment,accounting for 20.513%;there was no complete detachment in this group.There were statistically significant differences in the length of detachment,the height of detachment,the increase of corneal thickness in the detachment zone,and the increase ratio of corneal thickness in the detachment zone among different degrees of DMD(P<0.01).Pearson correlation analysis results showed that there were significant correlations between the length of detachment,the height of detachment,the increase of corneal thickness in the detachment zone and the increase ratio of corneal thickness in the detachment zone in DMD patients(P<0.01).Conclusion AS-OCT can quantitatively evaluate the severity of DMD after cataract surgery,which is helpful to guide its clinical diagnosis and treatment.

关 键 词：眼前节光学相干断层扫描 角膜后弹力层脱离 白内障 超声乳化术 

分 类 号：R779.66[医药卫生—眼科]