基于UBM不同分型的PACS行激光周边虹膜切除术后的有效性对比分析

Efficacy of laser peripheral iridotomy for different type of primary angle closure suspect based on UBM

目的对比分析单纯瞳孔阻滞型可疑性原发性房角关闭(PACS)及多种机制共存型PACS激光周边虹膜切除术(LPI)治疗后的有效性。方法收集陆军军医大学大坪医院眼科75例(85只眼)PACS患者临床资料,利用超声生物显微镜(UBM)对PACS分型,分成单纯瞳孔阻滞组(36只眼)及多种机制共存组(49只眼),对所有患者行LPI治疗,LPI术前及术后1周及3个月进行前节光学相干断层扫描技术(AS-OCT)检查,收集分析AS-OCT图像前房参数(AOD500、AOD750、TISA500、TISA750、ACV、ACD、ACW、CCT)测量值。结果 2组在行LPI术后1周及3个月分别与术前比较,AOD500、AOD750、TISA500、TISA750、ACV、ACD均明显增加(P<0.05),而ACW、CCT无明显变化(P>0.05)。2组术后1周及3个月组间比较,AOD500、AOD750、TISA500、TISA750单纯瞳孔阻滞组较多种机制共存组增加更加明显(P<0.05)。AOD500、AOD750、TISA500、TISA750术后1周及3个月与术前的差值2组间比较,单纯瞳孔阻滞组较多种机制共存组更大(P<0.05)。结论 PACS行LPI术后能显著增宽周边房角,并且单纯瞳孔阻滞型PACS效果较多种机制共存型PACS效果更佳。

Objective This thesis is aimed to compare and analyze the effectiveness of laser peripheral iridotomy（LPI） in treating pupillary block primary angle-closure suspect （PACS） and multimechanism PACS in eyes. Methods A total of 85 eyes of 75 patients with PACS in ophthalmology department of Daping hospital affiliated to army medical university were divided by using ultrasound biomicroscopy （UBM） into two groups：pupillary block PACS group（36 eyes） and muhimechanism PACS group（49 eyes）. All patients received LPI treat- merit, and the images of anterior chamber angle were collected by anterior segment optical coherence tomography（AS-OCT） at the time of before, 1 week and 3 months after treatment. Then, the parameter values （ AOD500, AOD750, TISA500, TlSA750, ACV, ACD, ACW, CCT） of anterior chamber in AS-OCT images were recorded. Results Comparing to the parameter values before treatment, AOD500,AOD750, TISAS00, TISA750, ACV and ACD significantly increased at the time of 1 week and 3 months after LPI in both groups （P 〈 0.05 ） ,while ACW or CCT remain unchanged （ P 〉 0.05 ）. Moreover, the increasement in AOD500, AOD750, TISA500 and TISA750 in pupillary block group was more significant than that in multimechanism group 1 week and 3 months after treatment （ P 〈 0.05 ）. The differences of AOD500, AOD750, TI- SA500 and TISA750 between pre-operation and post-operation（ 1 week and 3 months after treatment） in pupillary block group were more significantly increased than those in multimechanism group（P 〈 0.05 ）. Conclusion LPI can significantly increase the angle width in PACS, which is more effective for pupillary block group than muhimechanism group.