CAJ | 학술논문

目的回顾性观察分析角膜屈光手术前青光眼的排查情况.方法对屈光手术前发现可疑青光眼90例180只眼行青光眼排查,检查项目包括:24h眼压,前房角镜检查,角膜厚度,视野检查,眼底视网膜神经纤维层照相.将排查者分为3组:单纯高眼压组；单纯大杯组；高眼压+大杯组.排查患者的屈光状态、初诊眼压情况及以上检查内容,结合临床综合分析.结果屈光度＞-6.00 D的66只眼中原发性开角型青光眼(POAG) 38只眼；房角全部为宽开,表层神经纤维层缺损:阴性者114只眼,阳性者66只眼.其中高眼压组有12只眼,大杯组有22只眼,高眼压+大杯组有30只眼.中心视野检查,旁中心暗点28只眼,生理盲点扩大26只眼,弓型及鼻侧视野缩小2只眼.在可疑90例180只眼中,暂时排除青光眼14只眼,仍为可疑青光眼102只眼,早期POAG 62只眼,进展期青光眼2只眼.结论近视眼是青光眼患病的危险因素之一,屈光术前的青光眼排查很重要.高眼压同时伴有大杯,其青光眼发生率较高.眼底照相观察视盘及表层神经纤维缺损是诊断早期青光眼较为特异及敏感的指标.
목적 회고성관찰분석각막굴광수술전청광안적배사정황.방법 대굴광수술전발현가의청광안90례180지안행청광안배사,검사항목포괄:24h안압,전방각경검사,각막후도,시야검사,안저시망막신경섬유층조상.장배사자분위3조:단순고안압조；단순대배조；고안압+대배조.배사환자적굴광상태、초진안압정황급이상검사내용,결합림상종합분석.결과 굴광도＞-6.00 D적66지안중원발성개각형청광안(POAG) 38지안；방각전부위관개,표층신경섬유층결손:음성자114지안,양성자66지안.기중고안압조유12지안,대배조유22지안,고안압+대배조유30지안.중심시야검사,방중심암점28지안,생리맹점확대26지안,궁형급비측시야축소2지안.재가의90례180지안중,잠시배제청광안14지안,잉위가의청광안102지안,조기POAG 62지안,진전기청광안2지안.결론 근시안시청광안환병적위험인소지일,굴광술전적청광안배사흔중요.고안압동시반유대배,기청광안발생솔교고.안저조상관찰시반급표층신경섬유결손시진단조기청광안교위특이급민감적지표.
Objective To analyze the glaucoma investigation before the corneal refractive operation.Methods Ninety suspected glaucoma patients (180 eyes) were examined before the corneal refractive operation.Examinations included:24h intraocular pressure (IOP) fluctuation,gonioscopy,corneal thickness,visual field and fundus retinal nerve fiber layer photography.Detected patients were divided into 3 groups:simple high lOP group; simple large group; and high IOP combined with large group.Meanwhile,the refractive status and primary IOP of patients were also considered.Results There were 38 POAG of 66 eyes with diopter ＞-6.00D.The surface of nerve fiber layer:114eyes were negative and 64 eyes were positive.There were 12 eyes in high IOP group and 22 eyes in a large group.The group of high IOP combined with large had 30 eyes.By central visual field examination,it was found that 28 eyes had paracentral scotoma,26 eyes showed physiological blind spot enlarged and bow and nasal vision in 2 eyes were reduced.Fourteen eyes were temporarily excluded from glaucoma.One hundred and two eyes were suspicious glaucoma.Sixty-two eyes were diagnosed as early POAG.There were 2 advanced glaucoma cases.Conclusions The myopia is one of risk factors of glaucoma prevalence.It is very important to investigate glaucoma before refractive operation.It should be paid more attention that the incidence of glaucoma with high IOP accompanied by large is much higher.Observation of fundus images of optic disc and surface nerve fiber defects can be considered as a specific and sensitive index for the diagnosis of early glaucoma.