CAJ | 학술논문

目的观察原发性急性闭角型青光眼(PAACG)周边虹膜切除(SPI)术前后的眼前段相干光断层扫描(AS-OCT)参数改变.方法自身对照研究.连续性收集37例(37只眼)周边虹膜前粘连不超过5个钟点的PAACG发作期患者临床资料,进行回顾性自身对照研究.所有患者均于SPI术前及术后1个月行AS-OCT检查,检查项目包括中央前房深度、前房角开放距离、小梁网与虹膜间面积、前房角隐窝面积、前房宽度、前房容积及晶状体矢高.手术后与手术前检测参数比较,服从正态分布的采用配对t检验,不服从正态分布的采用配对秩和检验.结果 37例(37只眼)PAACG患者SPI手术前的AS-OCT检测参数:距巩膜突750 μm处,前房角开放距离(0.088 +0.078)μm、小梁网与虹膜间面积(0.050 +0.048)mm2、前房角隐窝面积(0.059±0.057) mm2、前房面积( 12.332±2.457) mm2、前房容积(73.131±16.976) mm3；SPI术后AS-OCT检测参数:距巩膜突750μm处,前房角开放距离(0.125±0.072) μm、小梁网与虹膜间面积(0.091±0.041 )mm2、前房角隐窝面积(0.095±0.042) mm2、前房面积(14.230 +2.000) mm2、前房容积(90.074±16.796 )mm3；SPI术后上述检测参数均高于术前,差异有统计学意义(t=-8.015～1.066,P=0.001 ～0.044).但中央前房深度、前房宽度及晶状体矢高与术前相比无明显变化,差异无统计学意义(t=- 1.505 ～0.516,P=0.102～0.609).结论 PAACG患者SPI术后可以解除瞳孔阻滞,使前房角开放距离、小梁网与虹膜间面积、前房角隐窝面积增宽,前房面积和容积增加,但前房深度和晶状体矢高不变.
목적 관찰원발성급성폐각형청광안(PAACG)주변홍막절제(SPI)술전후적안전단상간광단층소묘(AS-OCT)삼수개변.방법 자신대조연구.련속성수집37례(37지안)주변홍막전점련불초과5개종점적PAACG발작기환자림상자료,진행회고성자신대조연구.소유환자균우SPI술전급술후1개월행AS-OCT검사,검사항목포괄중앙전방심도、전방각개방거리、소량망여홍막간면적、전방각은와면적、전방관도、전방용적급정상체시고.수술후여수술전검측삼수비교,복종정태분포적채용배대t검험,불복종정태분포적채용배대질화검험.결과 37례(37지안)PAACG환자SPI수술전적AS-OCT검측삼수:거공막돌750 μm처,전방각개방거리(0.088 +0.078)μm、소량망여홍막간면적(0.050 +0.048)mm2、전방각은와면적(0.059±0.057) mm2、전방면적( 12.332±2.457) mm2、전방용적(73.131±16.976) mm3；SPI술후AS-OCT검측삼수:거공막돌750μm처,전방각개방거리(0.125±0.072) μm、소량망여홍막간면적(0.091±0.041 )mm2、전방각은와면적(0.095±0.042) mm2、전방면적(14.230 +2.000) mm2、전방용적(90.074±16.796 )mm3；SPI술후상술검측삼수균고우술전,차이유통계학의의(t=-8.015～1.066,P=0.001 ～0.044).단중앙전방심도、전방관도급정상체시고여술전상비무명현변화,차이무통계학의의(t=- 1.505 ～0.516,P=0.102～0.609).결론 PAACG환자SPI술후가이해제동공조체,사전방각개방거리、소량망여홍막간면적、전방각은와면적증관,전방면적화용적증가,단전방심도화정상체시고불변.
Objective To evaluate the changes of anterior segment configuration after surgical peripheral iridectomy (SPI)in patients with primary acute angle closure glaucoma (PAACG) by using anterior segment optical coherence tomography (AS-OCT).Methods This retrospective self control study consisted of thirty-seven eyes of 37 patients with PAACG who were consecutively recruited in Zhongshan Ophthalmic Center.The peripheral anterior synechiae (PAS) of these patients was less than 5 clock time point.Central anterior chamber depth (ACD),angle opening distance (AOD),trabecular iris area (TISA),angle recess area (ARA),anterior chamber width (ACW),anterior chamber volume (ACV),and crystalline lens rise (CLR) were measured using AS-OCT before and one month after SPI.Results After SPI,AOD (0.125 ±0.072) μm,TISA (0.091 ±0.041) mm2,ARA (0.095 ±0.042) mm2,ACA (14.230 ± 2.000) mm2 and ACV (90.074 ± 16.796) mm3 were significantly increased compared with before SPI AOD(0.088±0.078) μm,TISA (0.050 ±0.048)mm2,ARA(0.059 ±0.057) mm2,ACA(12.332 ±2.457)mm2,ACV (73.131 ± 16.976)mm3(t =-8.015 to 1.066,P =0.001 to 0.044),respectively.There were no significantly changes in ACD,ACW and CLR(t =- 1.505 to 0.516,P =0.102 to0.609).Conclusions PAACG can be controlled by SPI resulting in an increase of AOD,TISA,ARA,ACA and ACV,but not ACD or CLR.