超声检测晶状体参数在原发性闭角型青光眼发病机制中的作用分析

Research of lens parameter on pathogenesis of primary angle closure glaucoma via ultrasound examination

目的探讨晶状体在原发性闭角型青光眼（primary angle losureglaucoma，PACG）发病机制中的作用。方法采用超声生物显微镜、B超、和计算机图像处理软件对急性PACG患者40例（80只眼）、慢性PACG患者40例（80只眼）和正常人40名（80只眼）的眼前节参数进行测量和计算，对晶状体参数与前房深度和房角参数的相关性进行分析。结果急性和慢性PACG组与正常组比较，晶状体厚（包括中央部和周边部厚度）、前表面曲率大、相对位置偏前，差异有统计学意义（P〈0．01）；急性、慢性PACG组与正常组的晶状体直径、后表面曲率半径和体积进行组间比较，差异无统计学意义（P〉0．05）；急性和慢性PACG组的前房深度、房角开放距离和小梁虹膜夹角分别与晶状体前表面曲率半径和相对位置呈中度正相关（P〈0．01）。结论PACG的发病与晶状体解剖结构异常有关，包括晶状体厚，前表面曲率大和相对位置偏前。晶状体直径、体积和后表面曲率与发病未见相关关系。与急性PACG相比，慢性PACG眼前段拥挤程度相对较轻。

Objective To research lens parameters in the pathogenesis of primary angle closure glaucoma （PACG）. Methods Of 40 acute PACG in-patients （80 eyes）, 40 chronic PACG ones （80 eyes） and 40 healthy individuals with wide chamber angle （80 eyes）, parameters of ocular anterior segment were calculated and correlation analyzed among the lens parameters, anterior chamber depth and parameters of anterior chamber angle by B ultrasound, self-developed computer image processing soft- ware and ultrasound biomicroscope （UBM）. Results Compared with the normal group, PACG had thicker lens, steeper anterior surface curvature of lens and relatively more anterior lens position, among which there were statistically significant differences （P 〈0.01）, but no significant differences among the lens diameter, lens volume and the curvature radius of posterior lens surface （P 〉0.05）. For PACG, both the curvature radius of anterior lens surface and relative position of lens had moderately positive correlation with anterior chamber depth, angle open distance at 50013 m and trabecular iris angle （TIA） （P 〈0.01）. Conclusions The PACG pathogenesis show relevance to the abnormalities of lens anatomical structures, including the thicker lens, steeper curvature of anterior lens surface, and the relative more anterior position of lens. Lens diameter, its volume and its curvature of posterior surface do not confirm correlation with PACG. Compare with that of acute PACG, anterior segment of chronic PACG crowd relatively less.