LPI对原发性急性闭角型青光眼临床前期患者前房形态参数及眼压变化的影响

目的 探讨原发性急性闭角型青光眼临床前期YAG激光周边虹膜切除术(LPI)后前房形态参数及眼压变化情况.方法 选取2014年6月至2016年6月原发性闭角型青光眼患者90例,男39例,女51例.检查患者眼前节OCT,患者在缩瞳情况下收集眼前节OCT图像后行LPI,采用图像处理软件ImageJ1.46r对患者在治疗前后不同光照下OCT图像进行对比分析.结果 手术前后眼压和视力比较差异无统计学意义(P>0.05);治疗前患者房角平均开放度(10.40±4.31)°,治疗后房角开放度为(28.17±4.35)°,差异有统计学意义(P<0.05).前房水平截面积(ACCSA)在手术前和术后5周复查时对比差异有统计学意义(P<0.05);颞侧虹膜与鼻侧面积总和(ICSA)、瞳孔直径(PD)、中央角膜间距(CCT)在手术前和术后5周复查时对比差异无统计学意义(P>0.05);患者CACD在关闭灯光下参数对比有统计学意义(P<0.05).结论 患者手术后眼压、ICSA、PD、CCT未发生变化,LPI可以缓解患者瞳孔阻滞,加深周边前房,降低房角急性关闭的风险.

Objective To study the changes of anterior chamber morphological parameters and intraocular pressure(IOP)in patients with primary acute angle-closure glaucoma before preoperative YAG laser iridectomy. Methods Ninety patients(39 males and 51 females)with PACG who were treated in our hospital from June 2014 to June 2016 were selected. The OCT images of the anterior segment of the eyes were collected and the LPI was performed. The OCT images were analyzed by image processing software ImageJ1.46r before and after treatment in different illuminations. Results There was no difference in intraocular pressure and visual acuity before and after surgery(P>0.05). The mean openness of the patient's angle before treatment(10.40±4.31)°,and the open angle of the posterior angle of the treatment was(28.17±4.35)°,the difference was statistically significant(P<0.05).ACCSA had statistically significant difference before and 5 weeks after surgery(P<0.05).There was no significant difference in the lateral area sum(ICSA),pupil diameter(PD),and central corneal distance(CCT)before and 5 weeks after surgery(P>0.05),with statistical significance(P<0.05). Conclusion Patients with intraocular pressure after surgery,ICSA,PD,CCT did not change. LPI can relieve the patient pupil block,deepen the surrounding anterior chamber,reduce the risk of acute closure of the angle.