超声乳化联合人工晶状体植入术后前房角结构及眼压改变分析

Investigation the change of anterior chamber angle structure and intraocular pressure after phacoemulsification and intraocular lens implantation

目的观察白内障超声乳化摘除联合折叠式人工晶状体植入术后前房角结构及眼压的变化。方法临床病例对照研究。对2012年3-9月在宁夏医科大学总医院眼科选取具有正常前房深度、宽房角结构和浅前房、窄房角结构的白内障患者各30例（30只眼），均接受白内障超声乳化摘除联合人工晶状体植入术。使用超声生物显微镜（UBM）于术前及术后1个月、3个月对所有患者的前房角结构包括中央前房深度（ACD）、小梁虹膜夹角（TIA）、房角开放距离（AOD500）、小梁睫状体距离（TCPD）进行测量，同时进行前房角镜检查并记录眼压。对各项数据进行统计学分析。结果手术后1个月、3个月，两组患者均较术前前房加深、房角加宽、眼压下降，差异有统计学意义（P〈0．05），其中，浅前房窄房角组患者各项指标较术前变化更为明显，差异有统计学意义（P〈0．05）；对两组患者术后1个月、3个月的各前房角参数及眼压进行组内比较，差异无统计学意义（P〉0．05）。结论超声乳化摘除联合折叠式人工晶状体植入术能明显加深前房、开放房角、降低眼压，并且术后前房角结构及眼压的变化于1月后趋于稳定，可作为治疗闭角型青光眼合并白内障的一种手术方法。

Objective To study the influence on anterior chamber angle structure and intraocular pressure （IOP） of phacoemulsification and intraocular lens implantation. Methods Phacoemulsifica tion and intraocular lens implantation were performed in 60 eyes of 60 patients whom were divided into two groups： one group with shallow anterior chamber and narrow anterior chamber angle struc ture, another group with normal anterior chamber structure. All of the patients were measured values by ultrasound biomicroscopy （UBM） of ACD （anterior chamber distance）, TIA （trabecular iris angle）, AODS00 （angleopening distance at 500gin from the scleral spur）, and TCPD （Trabecular ciliary pro cesses distance） at the time before surgery and 1 month and 3 months after surgery. The IOP was also recorded at the same time. Results In both groups, the measurements of ACD, AOD500, TIA and TCPD were increased significantly and the IOP was reduced significantly after the operation （P 〈 0.05）. The measurements and the IOP changed more significantly in the shallow anterior chamber group than in normal anterior chamber group （P 〈0.05）. Comparing the measurements and the IOP one month after surgery with three months after surgery, there were no significant differences （P 〉 0.05）. Conclusions Phacoemulsiflcation and foldable intraocular lens implantation can significantlydeepen the anterior chamber, open the anterior chamber angle and reduce the IOP of the patients. So that it can avoid the occurrence of glaucoma and can be a surgery method of treating angleclo sure glaucoma combined cataract patients.