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

发布时间：2018-02-28 23:27

本文关键词： 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　出处：《眼科》2016年01期 　论文类型：期刊论文

【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500μm和750μm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),750μm处的参数变化较500μm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750μm处的参数的增幅均较巩膜突500μm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。
[Abstract]:Objective to evaluate the biomorphologic changes of atrial horn in patients with suspected primary atrial angle closure (PACSC) after laser peripheral iridotomy (LPI) 5 years after laser peripheral iridotomy (LPI) by ultrasound biomicroscopy (UBMM). A prospective case-control study was designed. Methods 42 consecutive patients with PACS in Handan Ophthalmology Hospital of Hebei Province were randomly selected to perform routine ophthalmology examination and UBM examination before and 5 years after LPI treatment. The main outcome measures of scleral processes in UBM images were 500 渭 m and 500 渭 m. The open angle of the atrium at 750 渭 m, the trabecular iris angle, the area of the recess of the atrium, the distance between the trabecular ciliary body and the thickness of the iris, etc. Results 42 patients were followed up for an average of 5.2 卤0.5) years. The AOD500A750TIA500TIA500TIA500TIA750ARA500 and ARA750 increased significantly 5 years after LPI. The parameters of TCPD500 and TCPD750 increased by 5% and 10 in 5 years after operation respectively, and the parameters of IT500 and IT750 decreased by 11% and 6 times respectively compared with those before operation. The parameters of TCPD500 and TCPD750 were more obvious after operation than those at 500 渭 m. The changes of the superior atrial angle of the eyes treated by laser were the largest, the change of the temporal side was the smallest, and the increase of parameters of the scleral process at 750 渭 m was larger than that of the scleral process at 500 渭 m. Compared with the contralateral eyes, the changes of the parameters of the upper atrium angle and the temporal side were higher than those of the control eyes except IT750 and IT500. The parameters measured in 5 years after laser operation were significantly increased (P < 0.05). Conclusion LPI can widen the anterior chamber angle of PACS eyes and has a good long-term effect.
【作者单位】：河北省承德医学院研究生院;河北省邯郸市眼科医院(邯郸市第三医院);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;温州医科大学附属眼视光医院;南京爱尔眼科医院;
【基金】：河北省科技攻关项目(06276102D-61)
【分类号】：R779.6

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