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目的观察原发性闭角型青光眼患者白内障超声乳化吸出联合人工晶状体植入手术前后的前房结构的变化。方法对18例(34眼)原发性闭角型青光眼合并白内障患者实施白内障超声乳化联合人工晶状体植入术,手术前后行眼前段相干光学断层扫描(optical coherence tomography,OCT),观察前房结构的变化。同时监测手术前后眼压,观察手术对闭角型青光眼的治疗作用。结果前段OCT扫描显示,手术后角膜前后曲率半径(7.53±0.81)mm、角膜陡峭度K值(44.46±4.64)dpt与术前(7.60±1.19)mm、(43.90±6.93)dpt相比差异均无统计学意义(P>0.05);前房深度、前房体积、500μm房角开放距离[(3.06±0.25)mm、(138.25±16.33)mm3、(0.62±0.35)mm]与术前[(2.29±0.22)mm、(94.50±27.28)mm3、(0.25±0.12)mm]相比,差异均有显著统计学意义(P<0.01);500μm小梁网虹膜间隙面积(0.26±0.15)mm2与术前(0.14±0.05)mm2相比,差异有统计学意义(P<0.05)。术后眼压在脱离药物治疗的情况下稳定于正常范围,术后视力均好于术前。结论前段OCT提供了对眼前节快速、非接触的检查方法。白内障超声乳化术对房角未全部粘连的闭角型青光眼有较好的治疗作用。
Objective To observe the changes of anterior chamber structure before and after cataract phacoemulsification combined with intraocular lens implantation in patients with primary angle-closure glaucoma. Methods Eighteen patients (34 eyes) with primary angle-closure glaucoma and cataract were treated with phacoemulsification combined with intraocular lens implantation. Anterior ocular segment coherence tomography (OCT) was performed before and after surgery. The anterior chamber structure The change. At the same time monitoring intraocular pressure before and after surgery to observe the effect of surgery on angle-closure glaucoma. Results The anterior segment OCT scan showed that the mean corneal curvature radius (7.53 ± 0.81) mm and corneal steepness K value (44.46 ± 4.64) dpt after surgery were significantly lower than those before surgery (7.60 ± 1.19) and (43.90 ± 6.93) dpt There was no significant difference between the two groups (P> 0.05). The anterior chamber depth, anterior chamber volume, the open distance of 500 μm angle [(3.06 ± 0.25) mm, (138.25 ± 16.33) mm3, (0.29 ± 0.22) mm, (94.50 ± 27.28) mm3, (0.25 ± 0.12) mm], respectively (P <0.01) The difference was statistically significant (P <0.05) before surgery (0.14 ± 0.05) mm2. Postoperative intraocular pressure in the case of drug treatment from the stability in the normal range, postoperative visual acuity were better than preoperative. Conclusions The anterior OCT provides a quick, non-contact examination of the anterior segment. Cataracts phacoemulsification of the corner of the angle not all of the angle closure glaucoma has a better therapeutic effect.