原发性急性闭角型青光眼双眼前房深度不对等的晶状体参数分析

Analysis of lens parameters in the inter-eye anterior chamber depth difference among patients with primary acute angle-closure glaucoma

目的分析晶状体参数在原发性急性闭角型青光眼(acute primary angle-closure glaucoma,APACG)双眼前房深度不对等中的作用。方法回顾性分析2018年1月1日—2021年8月1日石家庄市人民医院收治的38例(76眼)双眼前房深度不对等的APACG患者作为研究对象。急性发作眼(观察组)38眼,对侧眼(对照组)38眼。采用配对t检验比较两组术前中央前房深度(anterior chamber depth,ACD)、眼轴长度(axial length,AL)、晶状体厚度(lens thickness,LT)、晶状体拱高(lens vault,LV)、瞳孔缘相对位置(relative position of pupillary margin,RPOPM)、晶状体位置(lens position,LP)、晶状体相对位置(relative lens position,RLP)及前房拥挤率(chamber crowd ratio,CCR)变化。采用单变量线性回归方法分析影响ACD的相关参数。结果观察组ACD、LP、RLP低于对照组,LV、RPOPM、CCR高于对照组,差异有统计学意义(均P<0.01);两组间AL和LT比较,差异无统计学意义(P>0.05)。单变量线性回归分析显示,LV、RPOPM、CCR与ACD均成负相关(R2值分别为0.43、0.29、0.65,P<0.01);LP、RLP与ACD均成正相关(R2值分别为0.86、0.68,P<0.01)。结论LV高,RPOPM、LP、RLP靠前,CCR拥挤,可能是APACG双眼前房深度不对等的危险因素。

Objective To analyze the role of lens parameters in patients with acute primary angle-closure glaucoma(APACG)and the inter-eye anterior chamber depth(ACD)difference.Methods A retrospective analysis of 38 patients(76 eyes)with APACG and an unequal anterior chamber depth who were admitted to Shijiazhuang People’s Hospital from 1 January 2018 to 1 August 2021 was performed.The acute attack eyes(38 eyes)comprised the observation group and the contralateral eyes(38 eyes)served as the control group.A paired t-test was used to compare the differences in ACD,axial length(AL),lens thickness(LT),lens vault(LV),relative position of the pupillary margin(RPOPM),lens position(LP),relative lens position(RLP),and the chamber crowd ratio(CCR)between the two groups before operation.The univariate linear regression method was used to analyze the parameters affecting binocular ACD asymmetry.Results The ACD,LP,RLP in the observation group were significantly lower than those in the control group,the LV,RPOPM,CCR in the observation group were significantly higher than those in the control group(all P<0.01),the AL and LT in the two groups had no significantly difference(P>0.05).Univariate linear regression analysis revealed a negative correlation between the LV,RPOPM,CCR,and ACD(R2values were 0.43,0.29,and 0.65,respectively;P<0.01)and a positive correlation between the LP,RLP,and ACD(R2values were 0.86 and 0.68,respectively;P<0.01).Conclusion A high LV,anterior RPOPM,LP,RLP,and crowded CCR may be risk factors for the inter-eye ACD difference in patients with primary acute angle-closure glaucoma.