CAJ | 학술논문

目的应用Pentacam三维前房分析仪,测量原发性闭角型青光眼患者YAG激光周边虹膜切除术前、后前房形态参数变化,寻找以该检测方法评价前房形态变化的敏感指标.方法前瞻性对照研究.早期原发性闭角型青光眼(PACG)患者47例(47眼),其中急性PACG患者21例,慢性PACG患者26例,行YAG激光周边虹膜切除术.术前及术后2周分别行Pentacam三维前房分析仪检查,观察前房形态变化并分析术前、术后前房形态参数,即中央前房深度、前房容积及前房夹角的变化;同时比较急性PACG与慢性PACG以及用药与未用药组激光后前房形态参数变化.激光前、后眼前段参数比较采用配对t检验,激光后两组前房形态参数变化的比较采用独立样本t检验.结果 PACG患者激光术前中央前房深度为(1.84±0.31)mm,前房容积为(65.04±20.68)mm3,前房夹角为(25.44±6.38)°;激光术后中央前房深度为(1.89±0.28)mm,前房容积为(92.19±21.07)mm3,前房夹角为(23.86±5.96)°;术后中央前房深度、前房容积较术前变大,差异有统计学意义(t=-3.10,P=0.003;t=-17.02,P=0.000),前房夹角无明显改变(t=1.91,P=0.060).激光后,急性PACG患者前房容积增加值为(29.76±10.84)mm3,慢性PACG患者为(23.31±10.07)mm3,差异有统计学意义(t=2.09,P=0.040).随访1年以上,未用药眼压保持稳定者激光后前房容积增加值为(31.93±11.99)mm,经用药而使眼压保持稳定者为(18.71±7.06)mm3,差异有统计学意义(t=3.17,P=0.005).结论 YAG激光周边虹膜切除术可改善PACG患者的浅前房状态,前房容积与中央前房深度是应用Pentacam三维前房分析仪衡量前房形态变化的较敏感的参数.急性PACG患者激光后前房容积增加值较慢性PACG患者大,未用药眼压保持稳定的患者激光后前房容积增加值较经用药患者大.
목적 응용Pentacam삼유전방분석의,측량원발성폐각형청광안환자YAG격광주변홍막절제술전、후전방형태삼수변화,심조이해검측방법평개전방형태변화적민감지표.방법 전첨성대조연구.조기원발성폐각형청광안(PACG)환자47례(47안),기중급성PACG환자21례,만성PACG환자26례,행YAG격광주변홍막절제술.술전급술후2주분별행Pentacam삼유전방분석의검사,관찰전방형태변화병분석술전、술후전방형태삼수,즉중앙전방심도、전방용적급전방협각적변화;동시비교급성PACG여만성PACG이급용약여미용약조격광후전방형태삼수변화.격광전、후안전단삼수비교채용배대t검험,격광후량조전방형태삼수변화적비교채용독립양본t검험.결과 PACG환자격광술전중앙전방심도위(1.84±0.31)mm,전방용적위(65.04±20.68)mm3,전방협각위(25.44±6.38)°;격광술후중앙전방심도위(1.89±0.28)mm,전방용적위(92.19±21.07)mm3,전방협각위(23.86±5.96)°;술후중앙전방심도、전방용적교술전변대,차이유통계학의의(t=-3.10,P=0.003;t=-17.02,P=0.000),전방협각무명현개변(t=1.91,P=0.060).격광후,급성PACG환자전방용적증가치위(29.76±10.84)mm3,만성PACG환자위(23.31±10.07)mm3,차이유통계학의의(t=2.09,P=0.040).수방1년이상,미용약안압보지은정자격광후전방용적증가치위(31.93±11.99)mm,경용약이사안압보지은정자위(18.71±7.06)mm3,차이유통계학의의(t=3.17,P=0.005).결론 YAG격광주변홍막절제술가개선PACG환자적천전방상태,전방용적여중앙전방심도시응용Pentacam삼유전방분석의형량전방형태변화적교민감적삼수.급성PACG환자격광후전방용적증가치교만성PACG환자대,미용약안압보지은정적환자격광후전방용적증가치교경용약환자대.
Objective To evaluate the changes in anterior chamber morphology with the Pentacam three-dimension anterior segment analysis system after YAG laser peripheral iridectomy (LPI) in early primary angle closure glaucoma (PACG) patients in order to investigate the sensitive parameters of the anterior chamber changes. Methods Prospective control study. Forty-seven eyes of 47 PACG patients (acute PACG 21 eyes and chronic PACG 26 eyes) were enrolled in this study.Pentacam examination was performed before and 2 weeks after LPI to measure the central anterior chamber depth (ACD), the anterior chamber volume (ACV) and the peripheral anterior chamber angle (ACA). Statistical analysis included paired t test and independent samples t test. Results ACD increased significantly from (1.84±0.31)mm to (1.89±0.28)mm and ACV increased significantly from (65.04±20.68)mm3 to (92.19±21.07)mm3 after LPI in PACG (t=-3.10, P=0.003; t=-17.02, P=0.000).There was no statistical significance on the changes of ACA [(23.86±5.96)° vs (25.44±6.38)°, t=1.91,P=0.060) after LPI in PACG. The changes of ACV were (29.76±10.84)mm3 in acute PACG and (23.31±10.07)mm3 in chronic PACG. There was statistical significance between two groups (t=2.09, P=0.040).The changes of ACV were (31.93±11.99)mm3 in the patients without medicine and (18.71±7.06)mm3 in the patients with medicine. There was statistical significance between two groups (t=3.17, P=0.005).Conclusion LPI could increase the ACV and deepen the ACD in PACG. ACV and ACD are the sensitive parameters of the anterior chamber changes with Pentacam. The changes of ACV in acute PACG are more significant than that in chronic PACG. The changes of ACV in patients without medicine are more significant than that in patients with medicine.