玻璃体切割硅油填充术后眼前节OCT改变与眼压增高机制探讨

Mechanism discussion on parameters change of anterior segment optical coherence tomography and high intraocular pressure after vitrectomy and silicon oil tamponade

目的:探讨玻璃体切割硅油填充术后患者眼前节参数改变与眼压增高的关系及其机制。方法:选择玻璃体切割硅油填充术后高眼压患者65例(65只眼),利用眼前节OCT(ASOCT)观察记录术前,术后1周,术后1月,术后3月前房角开放距离(AOD500)、前房角隐窝面积(ARA)、中央前房深度(ACD)、前房面积(ACA)、小梁网虹膜间面积(TISA500)的参数变化。结果:玻璃体切除硅油填充术后AOD、ARA、TISA500低于术前,差异均具有统计学意义(P?0.05),手术前后ACD、ACA比较,差异无统计学意义(P<0.05)。结论:AS-OCT可以良好的定量测量玻璃体切割术后高眼压患者眼前段结构变化参数;玻璃体切割硅油填充术后眼前节OCT参数AOD500、ARA、TISA500降低与眼压增高有关;玻璃体切割硅油填充术后眼压增高的机制部分由术后硅油填充导致前房角结构变化,房水引流功能障碍导致。

Objective:To discuss the relationship between parameters change of anterior segment optical coherence tomography(AS-OCT)and high intraocular pressure after vitrectomy and silicon oil tamponade.Methods:65 cases(65eyes)patients of high intraocular pressure after vitrectomy and silicon oil tamponade were enrolled.The parameters including angle opening distance at 500μm(AOD500),angle recess area(ARA),central anterior chamber depth(ACD),the anterior chamber angle(ACA),trabecular iris area at 500μm(TISA500)were detected by AS-OCT at preoperative 1 day,postoperative 1 week,1 month and 3 months.Results:The datas after vitrectomy and silicon oil tamponade including angle opening distance at 500μm(AOD500),angle recess area(ARA)and trabecular iris area at 500μm(TISA500)were reduced than preoperative,there were statistical differences(P>0.05).The datas of ACD and ACA were no statistical differences(P<0.05).Conclusion:AS-OCT can quantify and exact measure anterior segment parameters of high intraocular pressure after vitrectomy and silicon oil tamponade.The postoperative parameters reduction of AOD500,ARA and TISA500 associated with increased intraocular pressure.The mechanism of high intraocular pressure after silicon oil tamponade is caused by changes of anterior chamber angle structure and aqueous humor drainage obstacle.