有晶状体眼人工晶状体植入术后前房形态观察

Observation on morphology of anterior chamber with Pentacam after implantation of posteriorchamber phakic intraocular lens

目的观察后房型有晶状体眼人工晶状体（PCP．IOL）植入术后前房形态改变。方法收集高度近视PCP—IOL植入术27例（53只眼）的临床资料，应用Pentacam观察术前、术后1个月和6个月的前房形态，进行回顾性分析。结果前房深度：术后1个月中央前房深度为（3．21±0．17）1／11／1，与术前的（3．22±0．25）mm相比差异无统计学意义。瞳孔直径4mm区域上方、颞侧、下方及鼻侧4个方位的前房深度及瞳孔直径6mm区域4个方位的前房深度均较术前下降，差异均有统计学意义。前房角：术后1个月平均前房角宽度为28．70°±6．14°，较术前的40．50°±7．28°下降，差异有统计学意义；上方、颞侧、下方及鼻侧前房角均较术前下降，差异有统计学意义。前房容积：术后1个月前房容积为（134．58±28．41）mm3，较术前的（236．21±17．19）mm3减小，差异有统计学意义。以上各指标术后6个月和1个月相比差异均无统计学意义。拱高：术后1个月拱高为（687．22±35．67）μm，术后6个月拱高为（683．54±31．01）μm，二者差异无统计学意义。眼压：术后1个月及6个月眼压分别为（18．27±2．14）mmHg和（17．86±1．95）mmHg（1mmHg=0．133kPa），与术前的（17．32±2．49）mmHg相比差异均无统计学意义。2只眼术后短期出现眼压升高，经降眼压治疗后降至正常。结论PCP—IOL植入术后前房形态改变明显，周边前房变浅，前房角变窄，前房容积减小，但随访期间观察指标数值稳定，远期效果尚需更长时间的密切观察。

Objective To observe the changes of anterior chamber morphology after implantation of posterior chamber phakic intraocular lens （PCP-IOL）. Methods Fifty-three eyes of 27 patients with high myopia who accepted P-ICL implantation were enrolled in this study. Anterior chamber were measured with Pentacam preoperatively and 1, 6 months postoperatively. The results were compared and analyzed retrospectively. Results The central anterior chamber depth at 1 month after operation was （3.21± 0.17） mm, there was no statistical difference compared with （ 3.22 ±0. 25 ）mm before operation. The peripheral anterior chamber depth in the area of 4 mm and 6 mm diameter decreased at the upper, temporal, lower and nasal sides 1 month after operation. One month after operation, the average width anterior chamber angle was reduced obviously from preoperative 40.50°±7.28° to postoperative 28.70°±6.14° ; and the same change appeared at the upper, temporal, lower and nasal sides, the differences were statistically significant between berore and after surgery. One month after operation, the anterior chamber volume was reduced from （236.21 ± 17.19 ） mm3 to （134.58 ± 28.41 ）mm3, the difference was statistically significant. There was no statistical difference in the values 1 and 6 months after operation. The IOL-vauh of 1 and 6 months after operation were （687.22 ± 35.67 ） μm and （683.54± 31.01 ） μm respectively, there was no statistical difference. The lOP of 1 and 6 month after operation were （18.27 ±2.14） mmHg and （17.86±1.95） mmHg（1 mmHg =0. 133 kPa）respectively, there was no statistical difference compared with （ 17.32± 2.49） mmHg before operation. Two eyes with high IOP in early period postoperatively which recovered soon after pressure-lowering treatment. Conclusion The anterior chamber morphology changes significantly after PCP-IOL implantation surgery. The peripheral anterior chamber depth, anterior chamber angle width, and anterior chamber volume decrease obviously affter operation, all the values are stable, but the long-term effect should be observed in the follow- up period.