Purpose:To analyze the causes of shallow anterior chamber after glaucoma surgery,and explore effective treatments correspondingly. Methods:A total of 183 glaucoma patients. (218 eyes).underwent trabeculectomy,and shal...Purpose:To analyze the causes of shallow anterior chamber after glaucoma surgery,and explore effective treatments correspondingly. Methods:A total of 183 glaucoma patients. (218 eyes).underwent trabeculectomy,and shallow anterior chambers were observed after surgery.The causes were analyzed and appropriate approaches were employed accordingly. Results:Postoperatively,shallow anterior chamber occurred in 42 eyes. (19.3% ).Among those, 24 eyes. (57.1% ).had excessive filtrations,8 eyes (19.0% )showed delayed anterior chamber formation,5 eyes (11.9% )presented with choroidal detachments ,4 eyes (9.5% )displayed conjunctival flap leak ages,and 1 eye (2.4% )had ciliary block. Most shallow anterior chambers can be effectively improved after appropriate treatment. Conclusion:Shallow anterior chamber can be caused by a variety of reasons, mainly by excessive filtration. We should actively take reasonable measures to improve the symptom and try to avoid its occurrence.展开更多
Objective To study the agreement between ophthalmologists and community health workers in detecting shallow anterior chamber with oblique flashlight test. Methods Totally 425 subjects were given an eye examination in ...Objective To study the agreement between ophthalmologists and community health workers in detecting shallow anterior chamber with oblique flashlight test. Methods Totally 425 subjects were given an eye examination in a community health center. The anterior chamber depth of each subject was examined by one ophthalmologist and two trained community health workers (one nurse and one non-professional health worker) using oblique flashlight test. Inter-observer agreement was determined using the weighted kappa statistic. Results Among the enrolled subjects,148 (35%) were male and 277 (65%) were female. Good agreement was noted in all the three observers. The comparison between the ophthalmologist and the nurse showed a kappa statistic of 0.42 for both eyes (P<0.001). The kappa statistic was 0.54 and 0.52 for right and left eyes respectively between the ophthalmologist and the non-professional health worker (P<0.001). As for agreement between the nurse and the non-professional health worker,the kappa statistic was 0.49 and 0.38 for right and left eyes,respectively (P<0.001). Conclusion The oblique flashlight test may be used as an applicable tool by trained community health workers for screening of shallow anterior chamber and play a role in blindness prevention in community.展开更多
Objective:To evaluate the prevalence of primary iris and/or ciliary body cysts in eyes with shallow anterior chamber and their effect on the narrowing of the anterior chamber angle.Methods:Among the general physical c...Objective:To evaluate the prevalence of primary iris and/or ciliary body cysts in eyes with shallow anterior chamber and their effect on the narrowing of the anterior chamber angle.Methods:Among the general physical check-up population,subjects with shallow anterior chambers,as judged by van Herick technique,were recruited for further investigation.Ultrasound biomicroscope(UBM) was used to detect and measure the cysts located in the iris and/or ciliary body,the anterior chamber depth(ACD),the angle opening distance at 500 μm(AOD500),and the trabecular-iris angle(TIA).A-scan ultrasonography was used to measure the ocular biometry,including lens thickness,axial length,lens/axial length factor(LAF),and relative lens position(RLP).The effect of the cyst on narrowing the corresponding anterior chamber angle and the entire angle was evaluated by the UBM images,ocular biometry,and gonioscopic grading.The eye with unilateral cyst was compared with the eye without the cyst for further analysis.Results:Among the 727 subjects with shallow anterior chamber,primary iris and ciliary body cysts were detected in 250(34.4%) patients;among them 96(38.4%) patients showed unilateral single cyst,21(8.4%) patients had unilateral double cysts,and 42(16.8%) patients manifested unilateral multiple and multi-quadrants cysts.Plateau iris configuration was found in 140 of 361(38.8%) eyes with cysts.The mean size of total cysts was(0.6547±0.2319) mm.In evaluation of the effect of the cyst size and location on narrowing the corresponding angle to their position,the proportion of the cysts causing corresponding angle narrowing or closure among the cysts larger than 0.8 mm(113/121,93.4%) was found to be significantly higher than that of the cysts smaller than 0.8 mm(373/801,46.6%),and a significant higher proportion was also found in the cysts located at iridociliary sulcus(354/437,81.0%) than in that at the pars plicata(131/484,27.1%).In evaluating the effect of the cyst on the entire anterior chamber angle,the eyes with multiple and multi-quadrants cysts manifested significant narrowing of the entire anterior chamber angle as compared with the eyes without cysts,based on the data analysis in comparison of TIA,AOD500,and gonioscopic grading evaluation.The unilateral single or double cysts in the eyes had no significant effect on narrowing of anterior chamber angle as compared with eyes without cysts.The iris and/or ciliary body cysts did not seem to affect the axial length,ACD,lens thickness,RLP,LAF.Conclusions:The prevalence of primary iris and ciliary body cyst was 34.4% in the subjects with shallow anterior chamber.The cysts larger than 0.8 mm,locating at iridociliary sulcus,or multiple and extensive cysts were inclined to cause the angle narrowing or closure.展开更多
AIM:To assess the changes of anterior chamber angle in patients with shallow anterior chamber after phacoemulsification combined with intraocular lens(IOL)implantation,based on anterior segment swept-source optical co...AIM:To assess the changes of anterior chamber angle in patients with shallow anterior chamber after phacoemulsification combined with intraocular lens(IOL)implantation,based on anterior segment swept-source optical coherence tomography(AS-SS-OCT)measurements.METHODS:This was a prospective case control study;sixty eyes of sixty case were scheduled for cataract surgery with normal intraocular pressure(IOP).Based on anterior chamber depth(ACD)and gonioscopy findings,the eyes were divided into two groups:group of shallow anterior chamber and narrow angle(SAC group,30 eyes);and group of normal anterior chamber group with wide angle(NAC group,30 eyes).Measurements of ACD,anterior chamber volume(ACV),iris volume(IV),lens vault(LV),angle opening distance(AOD),angle recess area(ARA),trabecular iris space area(TISA),and trabecular iris angle(TIA)were conducted in each group before and 3mo after surgery.RESULTS:There was no significant difference in age,axial length(AL),corneal curvature,corneal diameter,intraocular pressure,and IV between two groups before surgery,except for the LV(P=0.000).ACD and ACV were prominently larger in the NAC group than the SAC group 3mo after operation(3.69±0.38 vs 3.85±0.39 mm,P=0.025;161.37±19.47 vs 178.26±20.30 mm3,P=0.002).AOD750,ARA750 in nasal and inferior quadrants,TISA750 in all quadrants except temporal,and TIA750 in all quadrants in SAC group were significantly smaller than those in NAC group after operation(all P<0.05).CONCLUSION:Cataract surgery can deepen anterior chamber and increase the width of anterior chamber angle in Chinese subjects,but the angle related parameters including AOD750,ARA750,TISA750,TIA,TISA750,and ACV in patients with shallow anterior chamber and narrow angle do not reach the normal level.展开更多
文摘Purpose:To analyze the causes of shallow anterior chamber after glaucoma surgery,and explore effective treatments correspondingly. Methods:A total of 183 glaucoma patients. (218 eyes).underwent trabeculectomy,and shallow anterior chambers were observed after surgery.The causes were analyzed and appropriate approaches were employed accordingly. Results:Postoperatively,shallow anterior chamber occurred in 42 eyes. (19.3% ).Among those, 24 eyes. (57.1% ).had excessive filtrations,8 eyes (19.0% )showed delayed anterior chamber formation,5 eyes (11.9% )presented with choroidal detachments ,4 eyes (9.5% )displayed conjunctival flap leak ages,and 1 eye (2.4% )had ciliary block. Most shallow anterior chambers can be effectively improved after appropriate treatment. Conclusion:Shallow anterior chamber can be caused by a variety of reasons, mainly by excessive filtration. We should actively take reasonable measures to improve the symptom and try to avoid its occurrence.
基金Supported by Tsinghua-Yue-Yuen Medical Sciences Fund (20240000564) and Norwegian Fredskorpset Exchange Program
文摘Objective To study the agreement between ophthalmologists and community health workers in detecting shallow anterior chamber with oblique flashlight test. Methods Totally 425 subjects were given an eye examination in a community health center. The anterior chamber depth of each subject was examined by one ophthalmologist and two trained community health workers (one nurse and one non-professional health worker) using oblique flashlight test. Inter-observer agreement was determined using the weighted kappa statistic. Results Among the enrolled subjects,148 (35%) were male and 277 (65%) were female. Good agreement was noted in all the three observers. The comparison between the ophthalmologist and the nurse showed a kappa statistic of 0.42 for both eyes (P<0.001). The kappa statistic was 0.54 and 0.52 for right and left eyes respectively between the ophthalmologist and the non-professional health worker (P<0.001). As for agreement between the nurse and the non-professional health worker,the kappa statistic was 0.49 and 0.38 for right and left eyes,respectively (P<0.001). Conclusion The oblique flashlight test may be used as an applicable tool by trained community health workers for screening of shallow anterior chamber and play a role in blindness prevention in community.
基金Project (No. 2012KYA107) supported by the Health Bureau of Zhejiang Province,China
文摘Objective:To evaluate the prevalence of primary iris and/or ciliary body cysts in eyes with shallow anterior chamber and their effect on the narrowing of the anterior chamber angle.Methods:Among the general physical check-up population,subjects with shallow anterior chambers,as judged by van Herick technique,were recruited for further investigation.Ultrasound biomicroscope(UBM) was used to detect and measure the cysts located in the iris and/or ciliary body,the anterior chamber depth(ACD),the angle opening distance at 500 μm(AOD500),and the trabecular-iris angle(TIA).A-scan ultrasonography was used to measure the ocular biometry,including lens thickness,axial length,lens/axial length factor(LAF),and relative lens position(RLP).The effect of the cyst on narrowing the corresponding anterior chamber angle and the entire angle was evaluated by the UBM images,ocular biometry,and gonioscopic grading.The eye with unilateral cyst was compared with the eye without the cyst for further analysis.Results:Among the 727 subjects with shallow anterior chamber,primary iris and ciliary body cysts were detected in 250(34.4%) patients;among them 96(38.4%) patients showed unilateral single cyst,21(8.4%) patients had unilateral double cysts,and 42(16.8%) patients manifested unilateral multiple and multi-quadrants cysts.Plateau iris configuration was found in 140 of 361(38.8%) eyes with cysts.The mean size of total cysts was(0.6547±0.2319) mm.In evaluation of the effect of the cyst size and location on narrowing the corresponding angle to their position,the proportion of the cysts causing corresponding angle narrowing or closure among the cysts larger than 0.8 mm(113/121,93.4%) was found to be significantly higher than that of the cysts smaller than 0.8 mm(373/801,46.6%),and a significant higher proportion was also found in the cysts located at iridociliary sulcus(354/437,81.0%) than in that at the pars plicata(131/484,27.1%).In evaluating the effect of the cyst on the entire anterior chamber angle,the eyes with multiple and multi-quadrants cysts manifested significant narrowing of the entire anterior chamber angle as compared with the eyes without cysts,based on the data analysis in comparison of TIA,AOD500,and gonioscopic grading evaluation.The unilateral single or double cysts in the eyes had no significant effect on narrowing of anterior chamber angle as compared with eyes without cysts.The iris and/or ciliary body cysts did not seem to affect the axial length,ACD,lens thickness,RLP,LAF.Conclusions:The prevalence of primary iris and ciliary body cyst was 34.4% in the subjects with shallow anterior chamber.The cysts larger than 0.8 mm,locating at iridociliary sulcus,or multiple and extensive cysts were inclined to cause the angle narrowing or closure.
文摘AIM:To assess the changes of anterior chamber angle in patients with shallow anterior chamber after phacoemulsification combined with intraocular lens(IOL)implantation,based on anterior segment swept-source optical coherence tomography(AS-SS-OCT)measurements.METHODS:This was a prospective case control study;sixty eyes of sixty case were scheduled for cataract surgery with normal intraocular pressure(IOP).Based on anterior chamber depth(ACD)and gonioscopy findings,the eyes were divided into two groups:group of shallow anterior chamber and narrow angle(SAC group,30 eyes);and group of normal anterior chamber group with wide angle(NAC group,30 eyes).Measurements of ACD,anterior chamber volume(ACV),iris volume(IV),lens vault(LV),angle opening distance(AOD),angle recess area(ARA),trabecular iris space area(TISA),and trabecular iris angle(TIA)were conducted in each group before and 3mo after surgery.RESULTS:There was no significant difference in age,axial length(AL),corneal curvature,corneal diameter,intraocular pressure,and IV between two groups before surgery,except for the LV(P=0.000).ACD and ACV were prominently larger in the NAC group than the SAC group 3mo after operation(3.69±0.38 vs 3.85±0.39 mm,P=0.025;161.37±19.47 vs 178.26±20.30 mm3,P=0.002).AOD750,ARA750 in nasal and inferior quadrants,TISA750 in all quadrants except temporal,and TIA750 in all quadrants in SAC group were significantly smaller than those in NAC group after operation(all P<0.05).CONCLUSION:Cataract surgery can deepen anterior chamber and increase the width of anterior chamber angle in Chinese subjects,but the angle related parameters including AOD750,ARA750,TISA750,TIA,TISA750,and ACV in patients with shallow anterior chamber and narrow angle do not reach the normal level.
