闭角型青光眼合并白内障手术前后房角镜与OCT观察对比

Observation and comparison of gonioscope and OCT before and after angle-closure glaucoma complicated with cataractsurgery

目的评价闭角型青光眼合并白内障手术前后房角镜与光学相干层析成像(OCT)观察对比情况,为临床治疗提供参考、帮助。方法 23例(26眼)闭角型青光眼合并白内障行白内障超声乳化联合折叠式人工晶体植入术的患者,术前及术后1个月分别行视力、眼压、前房、裂隙灯、房角镜、OCT等检查,对比分析术前术后情况及二者检查情况。结果 23例(26眼)均顺利完成手术,无后囊膜破裂等并发症。术后眼压为(15.53±4.61)mm Hg(1 mm Hg=0.133 k Pa),低于术前的(37.30±3.29)mm Hg(P<0.01)。术前及术后4个对应方位进行相关样本非参数检验,结果显示OCT房角检查与房角镜检查结果比较差异无统计学意义(P>0.05),一致性好。结论白内障超声乳化联合折叠式人工晶体植入术是治疗闭角型青光眼合并白内障患者的有效治疗途径,可作为治疗这类疾病的首选方法之一。房角镜、OCT房角检查具有一致性。

Objective To evaluate observation and comparison of gonioscope and optical coherence tomography（OCT） before and after angle-closure glaucoma complicated with cataract surgery, and to provide reference and help for clinical treatment. Methods There were 23 patients（26 eyes） with angle-closure glaucoma complicated with cataract receiving phacoemulsification combined with folded intraocular lens implantation. Examination was made on vision, intraocular pressure, anterior chamber, slit lamp, gonioscope and OCT before and after 1 month of operation. Preoperative and postoperative status and examination were compared between the two groups. Results All 23 patients（26 eyes） received successful operation, without complications of posterior capsular rupture. They had lower postoperative intraocular pressure as（15.53±4.61） mm Hg（1mm Hg=0.133 k Pa） than（37.30±3.29） mm Hg before operation（P〈0.01）. Related sample non-parametric test was made on corresponding position before and after 4 months of operation, and it showed no statistically significant difference between OCT examination and gonioscope（P〉0.05）, along with good accuracy. Conclusion Combination of phacoemulsification combined with folded intraocular lens implantation is an effective treatment measure for angle-closure glaucoma complicated with cataract, and it can be applied as the preferred therapy. Gonioscope and OCT contain accuracy in examination.