可疑原发性房角关闭患者激光周边虹膜切除术后一年的房角生物测量分析

Long term outcomes of ultrasound biomicroscopy in eyes with primary angle closure suspect after laser peripheral iridotomy:one year results

目的应用超声生物显微镜(UBM)测量评价可疑原发性房角关闭(PACS)患者激光周边虹膜切除术(LPI)后的房角生物学形态变化。设计前瞻性病例系列。研究对象河北省邯郸市眼科医院连续的55例PACS患者。方法每例患者随机选取一眼行LPI治疗。LPI术前及术后12个月进行眼科常规检查及UBM检查。主要指标UBM图像房角参数。结果 LPI术后12个月时AOD500、AOD750、TCPD500、TCPD750、TIA500、TIA750、ARA500及ARA750较术前均明显增加(P均<0.001)。AOD750、TIA750及ARA750术后12个月时较术前增加幅度均在1倍以上(1.08～1.14倍)。LPI术后,激光眼上方房角的变化幅度最大,颞侧的变化幅度最小,且巩膜突750μm前的参数的增幅均较巩膜突500μm的参数增幅大。与对侧眼相比,除IT750与IT500以外,术后12个月各项参数的测量值均明显增加,差异具有显著性(P均<0.01)。且巩膜突750μm前的参数增幅均较巩膜突500μm增幅大。结论一年的随访研究显示,LPI能显著增宽PACS者周边前房角。巩膜突750μm前的参数在评价周边前房角上更为敏感。

Objective To quantitatively evaluate the long-term changes in anterior segment morphology by using of ultrasound biomicroscopy （UBM） after laser peripheral iridotomy （LPI） in eyes with primary angle closure suspect （PACS）. Design Prospective case series. Participants 55 PACS consecutive patients in Handan Eye Hospital, Hebei were enrolled. Methods Routine ophthalmic tests and UBM examination were performed at presentation and 12 months after LPI. Main Outcome Measures The parameters of anterior chamber angle in UBM images. Results AODS00, AOD750, TIAS00, TIA750, ARAS00, and ARA750 were significantly widen at 12 months after LPI than that at presentation in eyes with PACS （all P〈0.001）. The value of AOD, TIA and ARA after LPI were at least 1 time （1.08-1.14 times） wider than that of before LPI, and the parameters at 750 μm anterior to the sclera spur were more significantly wide than its 500 μm counterpart. Conclusion LPI can significantly widen the peripheral anterior angle in eyes with PACS and this effectiveness tends to be sustained at least 1 year after LPI. Parameters at 750 μm anterior to the sclera spur were more sensitive in e- valuating the peripheral anterior angle. （Ophthalmol CHN, 2013, 22： 244-248）