小梁切除术后持续性浅前房的发生与眼解剖因素相关性分析

Correlation analysis between occurrence of sustained shallow anterior chamber after trabeculectomy and ocular anatomical factors

目的探讨部分眼解剖因素与青光眼小梁切除术后持续性浅前房之间的关系。方法术前A超测量拟接受小梁切除手术的原发性闭角型青光眼患者24例(24眼)的中央前房深度(D)、晶状体厚度(L)和眼轴长度(A),并计算中央前房深度和眼轴长度的积与晶状体厚度的比值(D.A/L)。根据Spaeth分类法和术后浅前房的形成时间进行分组,如患者Ⅲ度浅前房持续1d以上,Ⅱ度浅前房持续5～7d以上需手术介入者,归入浅前房组(10例10眼);其他患者术后浅前房在7d内恢复正常者则归入正常组(14例14眼),统计分析两组上述参数的差异。结果眼轴长度:浅前房组(20.90±0.98)mm较正常组(22.43±0.95)mm短,差异具有显著统计学意义(P<0.01);中央前房深度:浅前房组(2.51±0.33)mm较正常组(2.28±0.18)mm深,差异具有统计学意义(0.01<P<0.05);晶状体厚度:浅前房组(4.52±0.38)mm较正常组(4.90±0.30)mm薄,差异具有显著统计学意义(P<0.01)。两组参数D.A/L分别为:浅前房组(11.74±2.33)mm和正常组(10.44±0.94)mm,差异无统计学意义(P>0.05)。结论眼轴短可能与原发性闭角型青光眼术后持续性浅前房的发生有关,提示术前进行眼轴长度测量的必要性。

Objective To discuss the relationship between some ocular anatomical factors and occurrence of sustained shallow anterior chamber after trabeculectomy.Methods The central anterior chamber depth（D）,lens thickness（L）and axial length（A）of 24 patients（24 eyes）with primary closed-angle glaucoma were measured by A-mode ultrasound before trabeculectomy,and ratio of the product of D and A to L（D×A/L）was calculated.According to Spaeth grouping and the sustained time of shallow anterior chamber,the patients were grouped,if the patients whose shallow anterior chamber with Ⅲ degree was over 1 day or with Ⅱ degree lasted from 5 days to 7 days and a surgical intervention was needed,fell into shallow anterior chamber group（10 cases,10 eyes）,and the rest whose shallow anterior chamber recovered to normal within 7 days fell into normal group.The differences of above parameters between two groups were statistical analyzed.Results The axial length of shallow anterior chamber group,which was（20.90±0.98）mm,was shorter than that of normal group,which was（22.43±0.95）mm,there was significant difference（P0.01）.The central anterior chamber depth of shallow anterior chamber group,which was（2.51±0.33）mm,was deeper than that of normal group,which was（2.28±0.18）mm,there was statistical difference（0.01P0.05）.The lens thickness of shallow anterior chamber group,which was（4.52±0.38）mm,was thinner than that of normal group,which was（4.90±0.30）mm,there was significant difference（P0.01）.The D×A/L parameter of shallow anterior chamber group and normal group were（11.74±2.33）mm and（10.44±0.94）mm,there was no statistical difference（P0.05）.Conclusion Among those risky factors of primary closed-angle glaucoma,only the shorter axial length is probably related with the occurrence of sustained shallow anterior chamber,which suggests it is necessary to measure the axial length preoperatively.