慢性闭角型青光眼双眼解剖参数差异分析

Analysis of the difference of binocular anatomic parameters in patients with chronic angle closure glaucoma

目的分析双眼视野缺损级别不同的慢性闭角型青光眼患者的双眼解剖生物测量参数的差异。方法将视野缺损级别较高的一眼归为试验组，视野缺损级别较低的另一眼归为对照组。测量两组的中央前房深度、晶状体厚度、眼轴长度、中央角膜厚度、角膜水平直径、角膜散光及角膜平均曲率。结果试验组的前房深度较对照组浅，分别为（2．00±0．34）mm和（2．07±0．31）mm，两者之间差异有统计学意义（t=-2．236，P=0。033）。其次试验组的中央角膜厚度较对照组薄，分别为（527．52±30．86）μm和（532．93±29．73）μm，两者之间差异有统计学意义（t=-3．615，P=0．001）。结论本研究显示浅前房是原发性慢性闭角型青光眼眼压升高和视功能损伤的关键因素。针对浅前房的影响晶体摘出加深前房是一种有效的治疗。其次本研究显示中央角膜厚度的变薄可能是慢性闭角型青光眼的早期定量诊断指标之一。

Objective To analyze the binocular characteristics of the anatomic parameters in patients with chronic angle closure glaucoma with binocular different levels of visual field. Methods Eleven cases （7 boys and 4 girls ） with consecutive esotropia were retrospectively reviewed. All patients had undergone lateral rectus surgery. The alterations in muscle position and prism diopers （PD）and deviational change were determined by subtracting the angle of deviation 1 week after the operation. To quantify the clinical effect of muscle advancement, the ratio of the change in muscle position and reduction to the change in visual angle deviation was calculated （the surgical dose-effect relationship）. Results The anterior chamber depth in the trial group was lower than in the control group, which were （2.00 ＋ 0.34） mm and （2.07 ＋ O. 31 ） mm, respectively and there was statistically significant difference between the two groups （ t = -2. 236 ,P = 0. 033）. The corneal thickness of the trial group was thinner than that in the control group, which were （527.52 ± 30.86 ） μm and （ 532.93 ± 29.73 ）μm respectively and there was a statistically significant difference between the two groups （t = - 3. 615,P = 0. 001 ）. Conclusion This study shows that the shallow anterior chamber is a key factor of elevated intraocular pressure and the visual function damage of primary chronic angle closure glaucoma. In view of the effect of shallow anterior chamber, the crystal removal to deepen the anterior chamber is an effective treatment. Second, this study shows that the thickness of the cornea may be a marker for the early quantitative diagnosis of chronic angle closure glaucoma.