小切口非超声乳化人工晶状体植入术后房角及眼压变化的相关性研究

Changes of Anterior Chamber Angle and Intraocular Pressure after Implantation of Intraocular Lens through Small Incision in a Non-phacoemulsification Way

目的研究小切口非超声乳化人工晶状体植入术后前房角宽度及眼压变化的相关性。方法选取2010年在我院就诊的老年性白内障患者110例,于表面麻醉下行小切口白内障囊外摘除人工晶状体植入术,将手术过程顺利、后囊膜完整、人工晶状体植入囊袋内的病例101例(104眼)作为研究对象。术前以超声生物显微镜(UBM)测量房角相关参数:500μm处前房角开放距离(AOD 500)、小梁虹膜夹角(TIA)、前房深度(ACD);以Goldmann眼压计测量眼压。分别于术后2周、1个月、3个月以UBM及Goldmann眼压计复查如上参数;术前以前房角镜观察并记录房角形态,于术后1个月复查房角形态。结果术前所测量的眼压与正常眼前节数据比较,差异有统计学意义(P<0.05);术前所测量的ACD、房角开放距离、TIA、眼压分别与术后2周、1个月、3个月复查数据比较,差异均有统计学意义(P<0.05),且房角开放距离和TIA均与眼压改变呈负相关。结论小切口非超声乳化人工晶状体植入术后,ACD及房角宽度显著增大,眼压显著降低。在老年人群中,房角开放距离、TIA是影响眼压的重要因素。

Objective To explore the correlation between the anterior chamber angle and intraocular pressure after the implantation of intraocular lens（iol） through small incision in a non-phacoemulsification way.Methods Totally 110 senile cataract patients admitted to our hospital in 2010 underwent implantation of iol with superficial anaesthesia through small incision.Among whom we chose 101 senile cataract patients（104 eyes） as the research subjects whose operation process was smooth and the posterior capsulars remained complete and iol successfully being implanted into capsular bag.Relevant parameters of anterior chamber including anterior open distance at 500μm（AOD500）,trabeculum-tunica coerulea included angle（TIA）,anterior chamber depth（ACD） were measured by ultrasonic biomicroscope（UBM） preoperatively.Intraocular pressures were measured by Goldmann ophthalmotonometer.All these parameters were re-measured by the same technician 2 weeks,1 month,and 3 months postoperatively.Morphouses of the anterior chambers were recorded preoperatively and re-recorded 1 month postoperatively through microgonioscope.Results Compared with the normal eyes,the intraocular pressure showed significant difference in these diseased eyes before surgery（P〈0.05）.ACD,AOD 500,TIA,and intraocular pressure before surgery were also significantly different from thoese 2 weeks,1 month,and 3 months after surgery（P〈0.05）.In addition,AOD 500 and TIA had a negative correlation with intraocular pressure.Conclusion Small incision of non-phacoemulsification and intraocular lens（iol） implantation might result in an enlargement of ACD and width of anterior chamber and a significant decrease of intraocular pressure.AOD500 and TIA are important factors that influence the intraocular pressure in the elderly.