前节光学相干断层扫描仪观察原发性闭角型青光眼激光虹膜周边切除术后前房形态的改变

Anterior segment optical coherence tomography for detecting the morphological changes of anterior chamber in patients with primary angle closure glaucoma after laser peripheral iridotomy

目的通过前节光学相干断层扫描仪(AS-OCT)观察原发性闭角型青光眼(PACG)激光虹膜周边切除术(LPI)后前房形态的改变。方法 30例(30只眼)PACG患者均行LPI,于行LPI前、后1周使用AS-OCT检查前房深度(ACD)、晶状体膨隆高度(CLR)、房角开放距离(AOD)、虹膜小梁空间面积(TISA)及瞳孔直径(PD),观察LPI前后前房形态的改变。结果手术前眼压为(15.923±2.028)mmHg(1 mmHg=0.133 kPa),术后1周为(14.523±1.650)mmHg,术后1周眼压显著低于术前,差异有统计学意义(P<0.05)。LPI前患者ACD、CLR、PD与手术后1周比较,差异均无统计学意义(P>0.05)。LPI后1周患者鼻侧AOD500、颞侧AOD500、鼻侧AOD750、颞侧AOD750、鼻侧TISA500、颞侧TISA500、鼻侧TISA750、颞侧TISA750及双侧平均AOD500、AOD750、TISA500、TISA750均显著大于手术前,差异均有统计学意义(P<0.01)。结论 LPI可以显著改善PACG患者眼前房结构,AS-OCT可以客观准确地观察PACG患者的前房形态。

Objective To observe the morphological changes of anterior chamber by anterior segment optical coherence tomography （AS-OCT） in patients with primary angle closure glaucoma（PACG） after laser peripheral iridotomy （LPI）. Methods Thirty patients （30 eyes） with PACG were treated with LPI. The morphological changes of anterior chamber were observed by detecting anterior chamber depth （ACD）, crystalline lens rise （CLR）, angle opening distance （AOD）, trabecular-iris space area（TISA） and pupil diameter （PD） before LPI and one week after LPI. Results Preoperative intraocular pressure was （15. 923 ± 2. 028） mmHg（ 1 mmHg = 0. 133 kPa）, the intraocular pressure of one week after operation was （14. 523 ± 1. 650） mmHg,the intraocular pressure of one week after operation was significantly lower than that before operation （P 〈 0. 05）. There was no significant difference in ACD, CLR and PD before and one week after LPI （ P 〉 0. 05 ）. The nasal AODS00, temporal AOD500, nasal AOD750, temporal AOD750, nasal TISA500, temporal TISAS00, nasal TISA750, temporal TISA750,and bilateral average AOD500, AOD750, TISA500, TISA750 after one week of LPI were significantly higher than those before LPI（P 〈 0. 01 ）. Conclusions LPI can significantly improve the structure of anterior chamber in patients with PACG. AS-OCT can objectively and accurately be used to observe the anterior chamber morphology of PACG patients.