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目的:运用Pentacam Schiempflug成像系统研究假性剥脱综合征(PES)患者白内障超声乳化术后眼前节形态变化。方法:前瞻性研究。共收集31例(42眼)白内障合并PES患者接受白内障摘除术,选27例(42眼)无PES的白内障患者作为对照组。Pentacam检测术前和术后1~3mo的眼内压(IOP),前房深度(ACD),前房容量(ACV),前房角宽度(ACA)和瞳孔直径(PD)。t检验检测术前和术后的变量。结果:PES组术前平均IOP明显高于对照组(P=0.017)。两组在术前和术后的ACD,ACV,ACA,IOP值差异在1~3mo均有统计学意义(P<0.05)。两组相比,PES组的IOP下降更为显著;两组ACD,ACV和ACA的增量相似。PES组术前PD值明显高于术后(P<0.05)。两组IOP,ACD,ACV,ACA和PD的变化在术后3mo均趋于稳定。结论:白内障超声乳化术均可显著降低患眼的IOP,增加ACD,ACV和ACA的值,无论患眼是否患有PES。ACD,ACV,ACA,PD和IOP的变化在术后3mo趋于稳定。尽管PES组IOP下降更为明显,但无论白内障眼是否患有PES,术后均表现出相似的眼前节特征。PES患者早期接受白内障摘除术不仅能加深前房,且可使IOP稳定在正常范围。
OBJECTIVE: To study the morphological changes of anterior segment of phacoemulsification after cataract phacoemulsification with Pentacam Schiempflug imaging system in patients with pseudo-exfoliation syndrome (PES). Methods: Prospective study. A total of 31 patients (42 eyes) with cataract combined with PES underwent cataract extraction, and 27 patients (42 eyes) with cataract without PES were selected as the control group. Pentacam detected intraocular pressure (IOP), anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle width (ACA) and pupil diameter (PD) before and 1 to 3 months after operation. t test to detect preoperative and postoperative variables. Results: The preoperative average IOP in PES group was significantly higher than that in control group (P = 0.017). Preoperative and postoperative ACD, ACV, ACA, IOP differences between the two groups in 1 ~ 3mo were statistically significant (P <0.05). Compared with the two groups, IOP decreased more significantly in PES group; the increment of ACD, ACV and ACA in both groups were similar. Preoperative PD in PES group was significantly higher than that in postoperative (P <0.05). Changes of IOP, ACD, ACV, ACA and PD in both groups tended to be stable after 3 months. CONCLUSIONS: Cataract phacoemulsification significantly reduces IOP in the affected eyes and increases the values of ACD, ACV and ACA, regardless of whether the affected eye has PES. Changes of ACD, ACV, ACA, PD and IOP tended to be stable after 3 months. Although the decline in IOP was more pronounced in the PES group, similar anterior segment characteristics were observed postoperatively, regardless of whether the cataract eye had PES. Early cesarean extirpation in PES patients not only deepens the anterior chamber but also stabilizes IOP in the normal range.