摘要
目的拟通过观察原发性前房角关闭眼（PAC）激光虹膜周边切除术（LPI）前后的改变，探讨PAC的房角关闭机制。方法应用前瞻性干预性系列病例研究。对ANA眼经暗光下UMB检查为PAC者48只眼，分为三组，A组，单纯性瞳孔阻滞组；B组，多种机制混合组；C组，单纯性非瞳孔阻滞组。对每组PAC眼进行LPI治疗，两周后暗光下行UMB检查，观察指标：AOD、TIA、IT1、TCPD、ILA、ILCD、SS—IR。结果（1）PAC的构成：单纯性瞳孔阻滞9只眼（18．75％），多种机制混合组39只眼（81．25％），无单纯性非瞳孔阻滞眼。多种机制混合组中，瞳孔阻滞＋睫状体前位7只眼（14．6％），瞳孔阻滞＋虹膜肥厚6只眼（12．5％），瞳孔阻滞＋睫状体前位＋虹膜肥厚26只眼（54．2％）。（2）LPI后房角开放率：A组LPI后房角开放率为100％（9／9），比B组41．0％（16／39）高（x^2=10．1910，P=0．001）。（3）A、B两组有关参数比较：B组LPI前周边虹膜厚度为（0．4029±0．0466）mm，比A组（0．3248±0．0520）mm厚（t=0．252，P〈0．05）；A组LPI后房角开放程度（AOD500、TIA）增加比B组明显（t=3．625、3．871，均P〈0．05）；A组LPI后虹膜膨隆程度（ILCD、ILA）与B组相似（t=1．680、1．110，均P〉0．05）；LPI后房角关闭点位的SS—IR比房角开放点位的短（t=2．480，P〈0．05）。结论PAC患眼多由混合机制引起（81．25％），LPI后的前房角关闭率高，睫状体前位及周边虹膜肥厚是导致PAC眼LPI后房角关闭的主要原因。
Objective To investigate the mechanisms of angle closure through observing changes of anterior segment morphology after laser peripheral iridotomy （LPI） in eyes with primary angle clo- sure （PAC）. Methods A prospective intervention observational case series. Forty-eight eyes with PAC, which were examined by ultrasound biomicroscopy （UBM） in darkness, were divided into three groups： The group A, simple pupillary block group; the group B, multi-mechanism group, the group C （0）, simple pure non-pupillary block group. Ultrasound biomicroscopy examination was car- ried out before and 2 weeks after LPI treatment was preformed on PAC. UBM parameters included AOD, TIA, IT1, TCPD, ILA, ILCD, SS-IR. Results 1. Composition of the PAC was： simple pupil- lary block group （9 eyes, 18.75%）; multiple mechanism group （39 eyes, 81.25%）; simple pure non-pupillary block group （0 eye, 0%）. In multiple mechanism group （39 eyes, 81.25%）, there were 14.6% （7 eyes） in pupillary blocking coexisting a anterior positioned ciliary body; 12.5% （6 eyes） in pupillary blocking coexisting a thicker iris; 54.2% （26 eyes） in pupillary blocking coexisting a thick- er iris and a anterior positioned ciliary body. 2. The rate of angle open after LPI was 100% （9/9） in simple pupillary block group, and 41.0% （16/39） in multiple mechanism group （P =0.001）. 3. The preoperative peripheral iris thickness of group B （0.4029±0.0466mm） was thicker than that of group A （0.3248±0.0520mm） （P 〈0.05）. Angle opening degree after LPI in group A were significantly in- creased （AOD500, TIA） compared with group B （P 〈0.05）. There were no significant differences in iris bombe degree （ILCD, ILA） between group A and group B after LPI （P 〉0.05）. After LPI, SS-IR in angle closure points were significantly shorter than in angle opening points （P 〈0.05）. Conclusions The mechanism of primary angle closure is main multiple mechanism. Both a thicker iris and an anterior positioned
出处
《中国实用眼科杂志》
CSCD
北大核心
2013年第11期1441-1444,共4页
Chinese Journal of Practical Ophthalmology
基金
贵州省科学技术基金项目（黔科合J字[2010]2183）
