CAJ | 학술논문

观察原发性前房角关闭（primary angle closure, PAC）行YAG激光周边虹膜切除术(laser peripheral iridotomy, LPI)后眼前节形态学的变化。方法：选择2012年3月至2013年3月在我院诊断为PAC并行LPI的患者28例（48眼）为研究对象，应用超声生物显微镜(ultrasound biomicroscopy, UBM)，观察LPI术前及术后1天、1周、1个月及3个月各时间点颞上、正上、正下、颞侧、鼻侧共5个位点的房角开放距离(angle opening distance, AOD500)、小梁虹膜夹角(trabecu-lar-iris angle, TIA)、小梁睫状体距离(trabecular ciliary process distance, TCPD)、虹膜睫状体距离(iris ciliary process distance ， ICPD)、虹膜晶体夹角(iris lens angle, ILA)、虹膜晶体接触距离(iris lens process distance, ILCD)、虹膜厚度1(iris thickness, ITl)、IT2、IT3以及中央前房深度(cental depth distance, ACD)的变化。结果：AOD500、TIA：术后较术前均增大（P＜0.05）；术后1周大于术后其余时间点（P＞0.05）。TCPD：除个别位点较术前增加（P＞0.05），其余时间点相应位点较术前增加（P＜0.05）；术后1周大于术后其余时间点（P＞0.05）。ILA：术后较术前均减小（P＜0.05）；术后1天至术后3个月逐渐增大（P＞0.05）。ILCD：术后较术前均增大（P＜0.05）,术后1天至术后3个月逐渐减小（P＞0.05）；IT1、IT2、IT3：术后较术前均减小（P＜0.05）；术后各时间点间比较（P＞0.05）。ACD：术后较术前增加（P＞0.05）。 LPI术前及术后各时间点平均ILA与平均ILCD的相关性显示二者呈高度负相关。结论：PAC患者行LPI术后周边前房明显加深，虹膜膨隆和瞳孔阻力减轻，但术后3个月内眼前节形态并不稳定，个别参考值有不同程度的回退，LPI术后有必要进行长期随访观察。
관찰원발성전방각관폐（primary angle closure, PAC）행YAG격광주변홍막절제술(laser peripheral iridotomy, LPI)후안전절형태학적변화。방법：선택2012년3월지2013년3월재아원진단위PAC병행LPI적환자28례（48안）위연구대상，응용초성생물현미경(ultrasound biomicroscopy, UBM)，관찰LPI술전급술후1천、1주、1개월급3개월각시간점섭상、정상、정하、섭측、비측공5개위점적방각개방거리(angle opening distance, AOD500)、소량홍막협각(trabecu-lar-iris angle, TIA)、소량첩상체거리(trabecular ciliary process distance, TCPD)、홍막첩상체거리(iris ciliary process distance ， ICPD)、홍막정체협각(iris lens angle, ILA)、홍막정체접촉거리(iris lens process distance, ILCD)、홍막후도1(iris thickness, ITl)、IT2、IT3이급중앙전방심도(cental depth distance, ACD)적변화。결과：AOD500、TIA：술후교술전균증대（P＜0.05）；술후1주대우술후기여시간점（P＞0.05）。TCPD：제개별위점교술전증가（P＞0.05），기여시간점상응위점교술전증가（P＜0.05）；술후1주대우술후기여시간점（P＞0.05）。ILA：술후교술전균감소（P＜0.05）；술후1천지술후3개월축점증대（P＞0.05）。ILCD：술후교술전균증대（P＜0.05）,술후1천지술후3개월축점감소（P＞0.05）；IT1、IT2、IT3：술후교술전균감소（P＜0.05）；술후각시간점간비교（P＞0.05）。ACD：술후교술전증가（P＞0.05）。 LPI술전급술후각시간점평균ILA여평균ILCD적상관성현시이자정고도부상관。결론：PAC환자행LPI술후주변전방명현가심，홍막팽륭화동공조력감경，단술후3개월내안전절형태병불은정，개별삼고치유불동정도적회퇴，LPI술후유필요진행장기수방관찰。
Objective To evaluate the changes in the anterior segment morphology by using ultrasound biomicroscopy (UBM) after YAG laser peripheral iridotomy (LPI) in eyes with primary angle closure (PAC). Methods From March 2012 to March 2013, 28 patients (48 eyes) who diagnosed with PAC and underwent LPI in our hospital, are regarded as the research object. By using the UBM, the following issues are observed on the superior temporal, above, below, bitamporal, and nasal side of the eyeball at 1 day, 1 week, 1 month and 3 months with the preoperative and postoperative of LPI:AOD500, TIA, TCPD, ICPD, ILA, ILCD, ITl, IT2, IT3 and ACD were included. Results AOD500, TIA were increased significantly(P<0.05), compared to before LPI; and the postoperative 1 week was more than the rest of the time after surgery (P > 0.05). TCPD was increased significantly, compared to before LPI(P < 0.05), in addition to individual sites ( P > 0.05 ); and postoperative 1 week were more than the others after sur-gery (P> 0.05). ILA were decreased (P< 0.05) in the postoperation compared to the preoperation; and ILA were increased gradual-ly from 1 day to 3 months after the operation(P > 0.05). ILCD were increased after LPI (P < 0.05), converse to ILA, ILCD were decreased gradually from 1 day to 3 months after the operation (P> 0.05). IT1, IT2, IT3 were decreased in the postoperation com-pared to preoperation (P < 0.05). ACD of postoperation was increased compared to before perfoming LPI(P > 0.05). Average ILA and average ILCD correlation shown that the two were highly negative correlation on every time points Conclusion The peripheral anterior chamber of PAC patients after the LPI were obviously deepened, the iris bombe and pupillary block were relieved after LPI. In addition, TCPD was increased, but the anterior segment morphology in the 3 months of postoperation was not stable, indi-vidual reference of which had some degree of retrograde. Therefore, long-term follow-up is necessary after LPI .