应用Oculyser眼前段分析系统对白内障手术前后角膜厚度和前房角宽度的测量

Quantitative measurement of the central corneal thickness and anterior chamber angle before and af- ter phacoemulsification by Oculyser

目的应用Oculyser眼前段分析系统对白内障行超声乳化吸出及后房型人工晶状体植入术手术前后中央角膜厚度（CCT）和前房角宽度（ACAD）的改变进行分析。方法60例（60只眼）白内障行超声乳化吸出及后房型人工晶状体植入术，分为老年性白内障组34例（34只眼）；糖尿病合并老年性白内障组（简称糖尿病组）26例（26只眼）。再按年龄段分为60～65岁组20只眼；66～75岁组20只眼；t〉76岁组20只眼。所有患眼应用Oculyser测量术前、术后3d、7d、1个月的CCT和ACAD，记录测量值。结果（1）中央角膜厚度：糖病组、老年性白内障组、各年龄组组内比较术后3d、7d的中央角膜厚度较术前增加（t=4．799～10．519，t=5．593～11．059，P〈0．05），1个月时和术前差异无统计学意义（t=1．441～3．126，P〉0．05）。糖尿病组和老年性白内障组中央角膜厚度比较术前和术后1个月差异无统计学意义（t=0．792，t=1．367，P〉0．05），而术后3d、7d时糖尿病组较老年性白内障组中央角膜厚度增加（t=2．282，t=2．077，P〈0．05）。各年龄组之间两两比较术前、术后3d、7d、1个月时中央角膜厚度差异无统计学意义（t=0．295—1．719，P〉0．05）。（2）前房角宽度：各组术后3d、7d、1个月的前房角宽度均较术前增加（t=6．281—11．869，t=7．926～10．939，t=8．504～12．912，P〈0．05）。同样时间条件下，糖尿病组和老年性白内障组比较、各年龄组差异均无统计学意义（t=0．056～0．980，t=0．003～1．098，P〉0．05）。（3）前房角宽度随着中央角膜厚度的恢复而增加，两者存在负相关关系（r=-0．330，P=0．010）。结论Oculyser眼前段分析系统可客观、准确地、观察白内障超声乳化吸出及后房型人工晶状体植入术前后前房角宽度及中央角膜厚度变化。

Objective To evaluate the changes of central corneal thickness （CCT） and anterior chamber angle depth （ACAD） before and after the phacoemulsification with posterior intraocular lens im- plantation through the eye anterior segment analysis system （Oculyser）. Methods Sixty eyes of 60 patients with cataract treated by phacoemulsification with posterior chamber intraocular lens implantation were en- rolled in this study, including 34 patients （ 34 eyes） without diabetes （ senile cataract group） and 26 pa- tients （26 eyes） with diabetes （diabetes group）. Then all patients with cataract were divided into 3 groups by age ： 60 - 65 years old group, 66 - 75 years old group, and over 76 years old group with 20 patients （20 eyes） in each group. The CCT and ACAD were examined by oculyser preoperatively and 3 d, 7 d, and 1 month postoperatively. Results （ 1 ） CCT： In the diabetes group, senile cataract group, and each age group, the CCT was significantly increased at 3 d, 7 d postopratively compared with that of preoperative CCT （t =4. 799 -10. 519,t =5. 593- 11. 059,P 〈0.05）. The CCT at 1 month postoperatively was not signifi- cantly different from the baseline （t = 1.441 - 3. 126 ,P 〉0.05）. Moreover, patients in diabetes group showedhigher CCT compared with those in senile cataract group at 3 d, 7 d （ t = 2. 282, t = 2. 077, P 〈 0.05 ） but not different at l month after surgery （ t = 0. 792, t = 1. 367,P 〉 0.05 ）. CCT in each age group did not show significant differences among preoperative and postoperative 3 d, 7 d, 1 month （t = 0. 295 - 1. 719, P 〉 0.05）. （2） ACAD： the ACAD was significantly increased after operation 3 d, 7 d, 1 month （t =6. 28l 11. 869, t =7. 926 - 10. 939, t =8. 504 - 12. 912, P 〈0.05）, but there were no significant differences be- tween patients with and without diabetes at different timepoints （ t = 0. 056 ~ 0. 980, t = 0. 003 - 1. 098, P 〉 0.05）. （3） The negative correlation was shown between the CCT and ACAD （r = -0. 330,P = 0. 010）. Conclusion The Oculyser can observe the changes of CCT and ACAD before and after cataract phacoemul- sification with posterior chamber intraocular lens implantation objectively and accurately.