慢性闭角型青光眼周边虹膜切除和滤过性手术前后眼前段结构参数的对比研究

眼科 ›› 2013, Vol. 22 ›› Issue (1): 19-24.

慢性闭角型青光眼周边虹膜切除和滤过性手术前后眼前段结构参数的对比研究

李媚王忠浩毛真刘杏

510060广州，中山大学中山眼科中心眼科学国家重点实验室

收稿日期:2012-11-29 出版日期:2013-01-25 发布日期:2013-01-30
通讯作者: 刘杏，Email：liuxing@mail.sysu.edu.cn　
基金资助:
广东省自然科学基金项目（S2012040007421）；眼科学国家重点实验室创新基金（2010C03）

Anterior segment optical coherence tomography changes after iridectomy or trabeculectomy in primary chronic angle-closure glaucoma

LI Mei, WANG Zhong-hao, MAO Zhen, LIU Xing.

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou 510060, China

Received:2012-11-29 Online:2013-01-25 Published:2013-01-30
Contact: LIU Xing, Email: liuxing@mail.sysu.edu.cn

摘要/Abstract

摘要： 目的观察原发性慢性闭角型青光眼（CPACG）周边虹膜切除和小梁切除术手术前后眼前段结构参数的改变。设计前瞻性比较性病例系列。研究对象中山眼科中心连续CPACG患者45例53眼。方法患者周边虹膜粘连范围≤6个钟点者行周边虹膜切除术，＞6个钟点者行小梁切除术，术前及术后3个月行眼前段光学相干断层扫描（AS-OCT）检查。比较两种术式术前及术后的眼前段AS-OCT检查参数。主要指标中央前房深度（ACD）、前房角开放距离（AOD）、小梁网虹膜间面积（TISA）、前房角隐窝面积（ARA）、前房宽度（ACW）、前房面积（ACA）、前房容积（ACV）和晶状体矢高（CLR）。结果周边虹膜切除术后ARA（0.078±0.036 mm2）、ACA（15.409±2.892 mm2）及ACV（91.021±22.387 mm3）较术前（ARA 0.065±0.024 mm2， ACA 13.945±2.633 mm2，ACV 83.445±21.791 mm3）明显增加（t=-8.015～-2.727，P=0.000～0.042），但手术前后AOD、TISA、ACD、ACW和CLR无变化（t=-1.374～0.561，P=0.102～0.774）。小梁切除手术前后各眼前段生物学参数的变化均无统计学意义（t=-1.700～-0.002，P=0.388～0.998）。结论原发性慢性闭角型青光眼周边虹膜切除术术后前房角隐窝面积、前房面积和前房容积增加，但小梁切除术后眼前段参数无明显改善。（眼科，2013，22：25-29）

关键词: 慢性闭角型青光眼, 前房角结构, 周边虹膜切除术, 小梁切除术, 前段光学相干断层扫描

Abstract: Objective To evaluate the changes in anterior segment configuration after surgical peripheral iridectomy (SPI) or primary trabeculectomy (PT) in chronic primary angle closure glaucoma (CPACG). Design Prospective comparative cases series. Participants Fifty-three eyes of 45 patients with CPACG from Zhongshan Ophthalmic Center, Sun Yat-Sen University were successively collected. Methods PI was performed in patients with the clock hours of peripheral anterior synechiae (PAS) ≤6, while PT was performed to patients with the clock hours of PAS>6. Anterior segment optical coherence tomography (AS-OCT) examination was performed before and 3 month after PI/PT. Main Outcome Measures Central anterior chamber depth (ACD), angle opening distance (AOD), trabecular iris area (TISA), angle recess area (ARA), anterior chamber width (ACW), anterior chamber area(ACA), anterior chamber volume (ACV) and crystalline lens rise (CLR). Results After surgery, ARA (0.078±0.036 vs. 0.065±0.024 mm2 ), ACA (15.409±2.892 vs. 13.945±2.633 mm2 ) and ACV (91.021±22.387 vs. 83.445±21.791 mm3 ) increased significantly (t=-8.015～-2.727, P<0.001～0.042), while no changes were found in ACD, TISA, AOD, ACW and CLR (t=-1.374～0.561, P=0.102～0.774) in SPI group. However in PT group, all AS-OCT parameters shown no changes(t=-1.700～-0.002, P=0.388～0.998) after operation. Conclusions After SPI, AS-OCT parameters such as ARA, ACA and ACV increase, while PT can not change the anterior segment configuration in CPACG eyes. (Ophthalmol CHN, 2013, 22: 25-29)

Key words: chronic angle-closure glaucoma, angle structure, iridectomy, trabeculectomy, anterior segment optical coherence tomography

李媚王忠浩毛真刘杏. 慢性闭角型青光眼周边虹膜切除和滤过性手术前后眼前段结构参数的对比研究[J]. 眼科, 2013, 22(1): 19-24.

LI Mei, WANG Zhong-hao, MAO Zhen, LIU Xing.. Anterior segment optical coherence tomography changes after iridectomy or trabeculectomy in primary chronic angle-closure glaucoma [J]. Ophthalmology in China, 2013, 22(1): 19-24.

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