Pentacam综合眼前节三维分析系统在原发性闭角型青光眼的诊断及YAG激光周边虹膜切开术疗效评价中的应用

发布时间：2018-08-19 18:47

【摘要】：目的：通过Pentacam综合眼前节三维分析系统测量正常人和原发性闭角型青光眼(primary angle-closure glaucoma, PACG)患者的前房形态参数：前房深度(anterior chamber depth, ACD)、前房容积(anterior chambervolume，ACV)、前房夹角(anterior chamber angle，ACA)。寻求原发性闭角型青光眼的早期筛查方法；应用Pentacam综合眼前节三维分析系统测量原发性急性闭角型青光眼临床前期眼和原发性慢性闭角型青光眼对侧眼YAG激光周边虹膜切开术前、术后前房形态参数变化，寻找前房形态变化的敏感指标并评价YAG激光周边虹膜切开术的疗效。方法：1正常对照组25眼与原发性急性闭角型青光眼缓解期25眼、原发性慢性闭角型青光眼25眼、原发性急性闭角型青光眼临床前期25眼、原发性慢性闭角型青光眼对侧眼25眼，应用Pentacam综合眼前节三维分析系统测量前房形态参数：前房深度(anterior chamber depth,ACD)、前房容积(anterior chamber volume，ACV)、前房夹角(anterior chamberangle，ACA)。2应用Pentacam综合眼前节三维分析系统测量原发性急性闭角型青光眼临床前期眼患者YAG激光周边虹膜切开术前与术后1天、7天、28天的前房形态参数：前房深度(anterior chamber depth, ACD)、前房容积(anterior chamber volume，ACV)、前房夹角(anterior chamber angle，ACA)。3应用Pentacam综合眼前节三维分析系统测量原发性慢性闭角型青光眼患者对侧眼YAG激光周边虹膜切开术前与术后1天、7天、28天的前房形态参数：前房深度(anterior chamber depth, ACD)、前房容积(anterior chamber volume，ACV)、前房夹角(anterior chamber angle，ACA)。4计算原发性急性闭角型青光眼临床前期眼YAG激光周边虹膜切开术后前房形态参数的变化：术后28天测量的前房形态参数值－术前测量的前房形态参数值；计算原发性慢性闭角型青光眼对侧眼YAG激光周边虹膜切开术后前房形态参数的变化：术后28天测量的前房形态参数值－术前测量的前房形态参数值。结果：1正常对照组与原发性急性闭角型青光眼缓解期、原发性慢性闭角型青光眼、原发性急性闭角型青光眼临床前期、原发性慢性闭角型青光眼对侧眼比较，正常对照组前房形态三种参数的测量值均大于其他各组，差异均有统计学意义(P 0.05)。原发性闭角型青光眼各组之间比较，差异无统计学意义。2原发性急性闭角型青光眼临床前期眼YAG激光周边虹膜切开术后各时间点前房深度较术前加深，前房容积较术前变大，差异有统计学意义（P 0.05），前房夹角值与术前比较，差异无统计学意义，，术后1天、7天、28天的前房深度值、前房容积值、前房夹角值比较，差异均无统计学意义。3原发性慢性闭角型青光眼患者对侧眼YAG激光周边虹膜切开术后各时间点前房深度较术前加深，前房容积较术前变大，差异有统计学意义（P 0.05）；前房夹角值与术前比较，差异无统计学意义，术后7天、28天与术后1天的前房深度、前房容积比较，差异有统计学意义（P 0.05）；术后7天、28天的前房深度、前房容积比较，差异无统计学意义。术后各时间点前房夹角值比较，差异无统计学意义。4原发性急性闭角型青光眼临床前期患者YAG激光周边虹膜切开术后前房深度增加值（术后28天前房深度-术前前房深度）、前房容积增加值(术后28天前房容积-术前前房容积)较原发性慢性闭角型青光眼患者对侧眼显著增大，差异有统计学意义结论：1Pentacam综合眼前节三维分析系统测量前房形态参数可以为原发性闭角型青光眼患者的筛查和早期诊断提供依据。2Pentacam综合眼前节三维分析系统可以用来量化评价YAG激光周边虹膜切开术后的眼前节形态的变化，为预后的评估提供参考。
[Abstract]:Objective: To investigate the anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA) in normal subjects and patients with primary angle-closure glaucoma (PACG) by Pentacam three-dimensional analysis system. Early screening for primary angle-closure glaucoma; Pentacam integrated anterior segment three-dimensional analysis system was used to measure the morphological parameters of anterior chamber before and after YAG laser peripheral iridotomy in primary acute angle-closure glaucoma and primary chronic angle-closure glaucoma. Objective to evaluate the efficacy of YAG laser peripheral iridotomy.
Methods: 1 25 eyes of normal control group, 25 eyes of primary acute angle closure glaucoma in remission stage, 25 eyes of primary chronic angle closure glaucoma, 25 eyes of primary acute angle closure glaucoma in preclinical stage, 25 eyes of primary chronic angle closure glaucoma in contralateral stage, and 25 eyes of primary chronic angle closure glaucoma in remission stage were measured by Pentacam three-dimensional analysis system. Anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA) were measured by Pentacam three-dimensional analysis system before and 1, 7, 28 days after YAG laser peripheral iridotomy in patients with primary acute angle-closure glaucoma. PARAMETERS: Anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA). 3 Pentacam integrated anterior segment three-dimensional analysis system was used to measure the contralateral YAG laser peripheral iridotomy in patients with primary chronic angle-closure glaucoma before and 1, 7, 28 days after surgery. Anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA). 4. Changes of anterior chamber shape parameters after YAG laser peripheral iridectomy in primary acute angle-closure glaucoma: Anterior chamber shape parameters measured 28 days after surgery Value-Preoperative measurement of anterior chamber shape parameters; Computation of primary chronic angle-closure glaucoma contralateral YAG laser peripheral iridectomy anterior chamber shape parameters changes: 28 days after the measurement of anterior chamber shape parameters-preoperative measurement of anterior chamber shape parameters.
Results: 1 Compared with the contralateral eyes of primary acute angle-closure glaucoma, primary chronic angle-closure glaucoma, primary acute angle-closure glaucoma and primary chronic angle-closure glaucoma, the measurement values of the three parameters of anterior chamber morphology in the normal control group were higher than those in the other groups. There was no significant difference between the groups of primary angle-closure glaucoma (P 0.05). 2 The depth of anterior chamber was deeper and the volume of anterior chamber was larger at each time point after YAG laser peripheral iridotomy in primary acute angle-closure glaucoma (P 0.05). There was no significant difference in the anterior chamber depth, anterior chamber volume and anterior chamber angle at 1, 7 and 28 days after surgery. 3 The anterior chamber depth and anterior chamber volume increased at different time points after YAG laser peripheral iridotomy in the contralateral eyes of patients with primary chronic angle-closure glaucoma. Significance (P 0.05); Angle between anterior chamber and preoperative, no significant difference, postoperative 7 days, 28 days and postoperative 1 day of anterior chamber depth, anterior chamber volume, the difference was statistically significant (P 0.05); postoperative 7 days, 28 days of anterior chamber depth, anterior chamber volume, no significant difference. Statistical significance.4 In primary acute angle-closure glaucoma, the increase of anterior chamber depth (anterior chamber depth-preoperative anterior chamber depth 28 days after YAG laser peripheral iridotomy) and anterior chamber volume (anterior chamber volume-preoperative anterior chamber volume 28 days after surgery) were significantly larger and worse than those in primary chronic angle-closure glaucoma. The difference was statistically significant.
Conclusion: 1 Pentacam integrated anterior segment three-dimensional analysis system can provide a basis for screening and early diagnosis of primary angle-closure glaucoma. 2 Pentacam integrated anterior segment three-dimensional analysis system can be used to quantify the changes of anterior segment morphology after YAG laser peripheral iridectomy, and to evaluate the prognosis. Provide reference.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R779.6

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