虹膜睫状体囊肿对后房型人工晶状体位置的影响

Effect of iris ciliary body cyst on posterior chamber intraocular len location

目的:用超声生物显微镜(ultrasound biomicroscopy,UBM)研究虹膜睫状体囊肿对后房型人工晶状体位置的影响。方法:在北京大学眼科中心行白内障超声乳化吸出人工晶状体植入术的患者,无角膜手术史,在白内障人工晶状体植入手术前行UBM检查,发现合并虹膜睫状体囊肿者20例(26眼),其中,双眼合并囊肿者6例(12眼),这12眼中只有8眼行白内障人工晶状体植入术,设无虹膜睫状体囊肿者17例(22眼)为对照组,白内障人工晶状体植入术后1mo,对这两组患者复行UBM检查,测量角膜内皮到人工晶状体前表面中央的距离,以及人工晶状体光学部外周12∶00,6∶00,3∶00,9∶00分别到角膜内皮的距离,人工晶状体襻的位置,虹膜睫状体囊肿的位置、大小。并且于术后1mo对这两组患者进行旋光视力检查。应用成组t检验方法分别对数据进行分析。结果:(1)虹膜睫状体囊肿的20例(22眼)和对照组白内障人工晶状体植入术后1mo旋光视力均数分别为4.78±0.15,4.89±0.10,(t=-2.30,P=0.03)。(2)虹膜睫状体囊肿患者20例(22眼)中,其人工晶状体外周12∶00,6∶00,3∶00,9∶00分别到角膜内皮的距离差值(最长与最短距离之差)的均数为(0.52±0.29)mm,对照组中人工晶状体光学部外周12∶00,6∶00,3∶00,9∶00分别到角膜内皮的距离差值的均数为(0.28±0.18)mm,两组t=2.26,P=0.03。(3)两组中虹膜后表面到人工晶状体前表面周边12∶00,6∶00的距离差值均数分别为(0.18±0.09)mm,(0.06±0.06)mm,(t=3.51,P=0.002)。(4)虹膜睫状体囊肿的20例(22眼)和对照组术后1mo的角膜内皮到人工晶状体前表面的中央距离均数分别为(3.77±0.10)mm,(3.66±0.29)mm,(t=1.34,P=0.20)。(5)本组虹膜睫状体囊肿大小不一,最大的囊肿矢状面面积为1.592mm2(最大矢状面面积),最小的囊肿矢状面面积为0.081mm2(最大矢状面面积)。1例(1眼)术前合并囊肿者,术后囊肿消失。结论:虹膜睫状体囊肿,对人工晶状体位置有一定影响,对术后患者的旋光视力有一定影响,对术后中央前房深度没有影响,囊肿术后可以消失。

AIM. To research the effect of iris ciliary body cyst on posterior chamber intraocular len location by using the Ultrasound biomicroscopy. METHODS. The patients, without corneal surgical history in Eye Center of Peking University, were examined by ultrasound biomicroscopy before underwent cataract ultrasound phacoemulsification and intraocular len implantation. It was found that 20 cases （26 eyes） were with ciliary body cyst. Thereinto, 6 cases （12 eyes） were with both biocular iris ciliary body cyst, in which, only 8 eyes received cataract IOL implantation. Seventeen cases （22 eyes） without ciliary body cyst were as control group. One month after cataract IOL implantation, the patients in two groups were rechecked by Ultrasound biomicros-copy, including measuring the distance from endothelial to the center anterior surface of IOL, the distance from endothelial to the IOL optic area outside surrounding 12 ： 00, 6 ： 00, 3 ： 00, and 9 ： 00, and the location of IOL, the location and size of iris ciliary body cyst. Glare visual acuity of these two groups was tested one month after operation. Data base was analyzed by using paired-t test. RESULTS： At postoperative month 1, the glare visual acuity means of 20 cases （22 eyes） in iris ciliary body cyst group and control group were 4.78±0.15 and 4.89±0.10 （ t = -2.30, P = 0.03）. The means of difference distances （the difference between the longest and shortest） from endothelial to the IOL outside surrounding of 20 cases （26 eyes） in iris ciliary body cyst group and from endothelial to the IOL optic area outside surrounding of eyes in control group at 12 ： 00, 6 ： 00, 3 ： 00, and 9 ： 00 were （0.52±0. 29） mm and （0. 28±0. 18） mm, respectively, （ t = 2.26, P = 0.03）. The means of difference distance from iris posterior surface to the IOL anterior surface surrounding 12 ： 00, and 6 ： 00 in two groups were （0.18±0.09）mm and （0.06±0.06）mm （t=3.51, P= 0. 002）. The means of center distance from endothelial to the IOL anterior surface in 20 cases （26 eyes） with ciliary body cyst and in control group one month after operation were （3.77±0.10）mm and （3.66±0.29）mm （t= 1.34, P= 0.20）. In iris ciliary body cyst group, iris ciliary cysts were unequal size, the biggest arrowy proportion of cyst was 1. 592mm^2, and the smallest was 0. 081 mm^2. The cyst was gone after operation in 1 case （1 eye） with cyst. CONCLUSION： Iris ciliary cyst has certain influence to the location of IOL, also to the glare visual acuity of patients who performed surgery. Iris ciliary cyst has no influence to the center depth of anterior chamber and the cyst can disappear after surgery.