原发性闭角型青光眼行超声乳化白内障摘出术后前房形态的远期变化观察

Long-term observation of anterior chamber morphous after phacoemulsification in pri mary angle-closure glaucoma

目的观察原发性闭角型青光眼（primary angle-closure glaucoma，PAcG）患者行超声乳化白内障摘出术后前房形态的远期变化。方法回顾性分析2009年1月至2012年1月我院收治的PACG患者48例（48眼）的临床资料，所有患者均行超声乳化白内障摘出术，分别于术前、术后3个月检查患者裸眼视力和眼压，同时利用0cT检查前房相关参数变化。结果术前患者裸眼视力为数指～0．5（0．16±0．08），术后3个月为0．2～0．8（0．45±0．12），差异有显著统计学意义（P〈0．01）。术前眼压为22～38（27．6±3．5）mmHg（1kPa=7．5mmHg），术后3个月为12～21（13．8±5．2）mmHg，差异有统计学意义（P〈0．05）。术后患者中央前房深度、周边前房深度、前房容积及500μm房角开放距离均显著增加，与术前比较，差异均有统计学意义（均为P〈0．05）；术后瞳孔直径较术前降低，但差异无统计学意义（P〉0．05）。与术前相比，术后各象限前房角均增宽，差异均有统计学意义（均为P〈0．05）。结论超声乳化白内障摘出术可有效改善PAcG患者眼前段结构的狭窄情况。

Objective To observe the long-term morphous changes in anterior chamber after phacoemulsification in patients with primary angle-closure glaucoma （PACG）. Methods Forty-eight patients （48 eyes） with PACG in our hospital from January,2009 to January,2012 were retrospectively analyzed. All patients received phac- oemulsification, uncorrected visual acuity and intraocuiar pressure before and 3 months after operation were examined, and related parameters of anterior chamber were ob- served by Pentacam and OCT. Results Uncorrected visual acuity before and 3 months after operation was from finger counting to 0.5 （0. 16 ± 0.08 ） and from 0.2 to 0. 8 （0.45 ±0.12） ,respectively,and the difference had statistical significance（P 〈0.01 ）. In- traocular pressure before and 3 months after operation was from 22 mmHg to 38 mmHg （27.5 ±3.5）mmHg and from 12 mmHg to 21 mmHg （ 13.8 ± 5.2） mmHg, respectively, and the difference had statistical significance （P 〈 0.05 ）. Anterior chamber depth, pe-ripheral anterior chamber depth, anterior chamber volume and 500 μm chamber-angle open distance significantly increased, and the differences were of statistical significance （ all P 〈 0.05 ） compared with those before surgery. Pupil diameter de- creased than that before operation, but had no statistical significance （P 〉 0.05 ）. Anterior chamber at each quadrant was wi- der after operation compared with that preoperation, and the difference had statistical significance （ all P 〈 0.05 ）. Conclu- sion Phacoemulsification may effectively improve stenosis of anterior segment structure in patients with PACG.