超声生物显微镜在青光眼白内障联合手术中的应用

Ultrasound biomicroscopy used in combined surgery for glaucoma and cataract

目的:利用超声生物显微镜(UBM)检查结果来指导青光眼合并白内障患者术前手术方法的选择,观察患者术后房角及其相关结构的改变。方法:对合并白内障的原发性闭角型青光眼患者30例(30只眼)行小梁切除术联合白内障超声乳化及人工晶状体植入。术前及术后1个月用UBM测量前房深度(ACD)、小梁虹膜角(TIA)、房角开放距离500(AOD500)、小梁睫状体距离(TCPD)和虹膜厚度1(ID1),同时记录眼压的变化并进行分析。结果:术后眼压较术前明显降低。ACD、TIA、AOD500和TCPD与术前比较均有显著性差异(P<0.05)。ID1与术前比较无显著性差异(P>0.05)。结论:青光眼白内障联合手术可明显加深前房,增宽房角,重新开放小梁网,这有助于更好地控制眼压,减少术后浅前房等并发症的发生。远期效果有待于更多的病例积累、更长时间的术后观察。

Objective ： To evaluate ultrasound biomicroscopy （UBM） in coma complicated by cataract and in the observation of the post-operation c the surgical treatment of glauhanges of the anterior chamber angle and its related structure in patients with primary angle-closure glaucoma （PACG）. Methods： Combined surgery of phacoemulsification, intraocular lens （IOL） implantation and trabeculectomy was performed in 30 patients （30 eyes） with cataract and PACG. The changes of the anterior chamber angle and anterior chamber distance were determined by UBM before and 1 month after the operation. At the same time, intraocular pressure was recorded and analyzed. Results：Intraocular pressure was obviously decreased after the operation. There were significant differences between pre- and post-operation in ACD, AOD500, TIA and TCPD （ P 〈 0.05 ） but not in ID1 （ P 〉 0.05）. Conclusion ： Combined surgery for glaucoma and cataract could deepen the anterior chamber, widen the chamber angle, and reopen the trabeculae, which contributes to the control of intraocular pressure and reduces postoperative complications such as shallow anterior chamber. Long-term effect of the surgery needs to be further investigated.