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可疑原发性房角关闭患者激光周边虹膜切开术后远期房角生物测量分析

吕爱国  牟大鹏  郭黎霞  梁远波  李思珍  崔宏宇  张志宏  范肃洁   

  1. 067000 河北省承德医学院研究生院(吕爱国);056001河北省邯郸市眼科医院(邯郸市第三医院)(吕爱国、郭黎霞、崔宏宇、张志宏、范肃洁);100730 首都医科大学附属北京同仁医院 北京同仁眼科中心 眼科学与视觉科学北京市重点实验室(牟大鹏);325027温州医科大学附属眼视光医院(梁远波);210006 南京爱尔眼科医院(李思珍)
  • 收稿日期:2015-11-06 出版日期:2016-01-25 发布日期:2016-01-28
  • 通讯作者: 范肃洁,Email:fansujie3@163.com
  • 基金资助:

    河北省科技攻关项目(06276102D-61)

Long-term outcomes of ultrasound biomicroscopy in eyes with primary angle closure suspect after laser peripheral iridotomy: a five-year progression study 

LV Ai-guo1, 2, MU Da-peng3, GUO Li-xia2, LIANG Yuan-bo4, LI Si-zhen5, CUI Hong-yu2, ZHANG Zhi-hong2, FAN Su-jie2   

  1. 1. Chengde Medical College of Hebei Province, Chengde 067000, China; 2. Handan Eye Hospital, Hebei 056001, China; 3. Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; 4. The Affiliated Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, China; 5. Nanjing Aier Eye Hospital, Nanjing 210006, China
  • Received:2015-11-06 Online:2016-01-25 Published:2016-01-28
  • Contact: FAN Su-jie,Email:fansujie3@163.com

摘要:

目的 通过超声生物显微镜(UBM)测量分析评价可疑原发性房角关闭(PACS)患者激光周边虹膜切开术(LPI)后5年的房角生物形态学变化。设计 前瞻性病例对照研究。研究对象 河北省邯郸市眼科医院连续的PACS患者42例。方法 每例患者随机选取一眼行LPI治疗。LPI术前及术后5年时进行眼科常规检查及UBM检查。主要指标 UBM图像巩膜突前500 μm和750 μm处的房角开放距离(AOD)、小梁虹膜夹角(TIA)、房角隐窝面积(ARA)、小梁睫状体距离(TCPD)、虹膜厚度(IT)等参数。结果 42例患者平均随访(5.2±0.5)年。LPI术后5年时AOD500、AOD750、TIA500、TIA750、ARA500及ARA750较术前均明显增加(P均<0.001),TCPD500与TCPD750在术后5年分别增加了5%和10%(P均<0.05),IT500、IT750分别较术前减少11%和6%(P均<0.05),750 μm处的参数变化较500 μm处更明显。LPI术后,激光干预眼的上方房角变化幅度最大,颞侧的变化幅度最小,且巩膜突750 μm处的参数的增幅均较巩膜突500 μm处的参数增幅大。与对侧眼相比,除IT750与IT500以外,激光术后5年的各项参数的测量值均明显增加(P均<0.05)。结论 LPI可增宽PACS患眼的前房角,并具有较好的远期效果。(眼科,2016, 25: 23-29)

关键词: 可疑原发性房角关闭, 激光周边虹膜切开术, 超声生物显微镜

Abstract:

 Objective To quantitatively evaluate the long-term changes in anterior segment morphology with ultrasound biomicroscopy (UBM) after laser peripheral iridotomy (LPI) in eyes with primary angle closure suspect (PACS). Design Prospective case series study. Participants 42 PACS consecutive patients in Handan Eye Hospital, Hebei were enrolled. Method LPI was performed in one eye selected randomly for every PACS. Routine ophthalmic tests and UBM examination were performed at presentation and 5 years after LPI. Main Outcome Measures The parameters of anterior chamber angle ahead 500 μm and 750 μm of scleral spur, such as angle opening distance (AOD), trabecular-iris angle (TIA), angle recess area (ARA) trabecular-ciliary process distance (TCPD) and iris thickness (IT) on UBM images. Results The mean follow-up period was (5.2±0.5) years in 42 patients. AOD500, AOD750, TIA500, TIA750, ARA500, and ARA750 were significantly widen at 5 years after LPI than that at presentation in eyes with PACS (all P<0.001). IT500, IT750 were significantly decreased 11% and 6% respectively at 5 years after LPI than that at presentation in eyes with PACS (all P<0.001), and the parameters at 750 μm anterior to the sclera spur were more significantly wide than its 500 μm counterpart. Conclusion LPI can significantly widen the peripheral anterior angle in eyes with PACS and this effectiveness to be sustained at least 5 years after LPI.  (Ophthalmol CHN, 2016, 25: 23-29)

Key words: primary angle closure suspect, laser peripheral iridotomy, ultrasound biomicroscopy