超声乳化手术治疗慢性闭角型青光眼术前晶状体厚度的研究

Usage of lens thickness for evaluating intraocular pressure control in chronic angle-closure glaucoma after phacoemulsification

目的评价晶状体厚度对白内障超声乳化摘出联合人工晶状体植入治疗慢性闭角型青光眼手术效果的影响。方法对30例（36眼）慢性闭角型青光眼行白内障超声乳化摘出联合人工晶状体植入术，手术前后行超声生物显微镜（ultrasound biomicroscopy，UBM）检查。根据手术前的晶状体厚度分为晶状体厚度增大组（20眼）和晶状体厚度正常组（16眼）。术后随访11—30周。结果晶状体厚度增大组术后早期及随访时眼压平均下降（15．05±3．68）mmHg（1mmHg：0．133kPa）及（10．42±4．98）mmHg，晶状体厚度正常组则分别下降（9．88±4．60）mmHg及（7．50±4．58）mmHg。两组的手术成功率分别为95．0％和62．5％，差异有统计学意义。结论白内障超声乳化摘出联合人工晶状体植入术治疗闭角型青光眼，术前以UBM测量晶状体厚度，可对手术的降眼压效果及术后远期疗效作出评估。

Objective To determine the influence of lens thickness （LT） on the clinical outcome of intraocular pressure （lOP） reduction after phacoemulsification and intraocular lens（IOL） implantation in chronic angle-closure glaucoma（CACG）. Methods Thirty-six eyes with cataract from 30 patients of CACG had phacoemulsification and IOL implantation. Ultrasound biomicroscopy （UBM） was performed before and after the surgery. Participants were assigned to the increased LT group（20 eyes） and the normal LT group（ 16 eyes） based on the preoperative LT. All patients were followed up for 11- 30 weeks. Results The mean postoperative reduction of IOP in the increased LT group was （ 15.05 ± 3.68）mm Hg immediately after the surgery and （10.42±4.98）mm Hg in the follow-up exams. The corresponding values in the normal LT group were （9.88 ±4.60）mm Hg and （7.50 ±4.58）mm Hg respectively. There was significant difference in the success rate between the increased LT group （95.0%） and the normal LT group （62.5%）. Conclusions Postoperative and long-term effects of the phacoemulsification and IOL implantation on lOP reduction in CACG patients can be evaluated bv oreooerative LT with UBM.