摘要
目的评估超声生物显微镜（UBM）观察原发性房角关闭（PAC）激光虹膜周边切除术（LPI）后眼压失控患者房角解剖结构特点与眼压变化情况，分析与手术疗效相关的影响因素。方法采用回顾性病例对照研究方法，收集2014年6月至2015年9月在河南省眼科研究所诊断为PAC的患者58例58眼的临床资料，年龄41～68岁，平均（52．69±9．07）岁；眼压10．3—20．0mmHg（1mmHg=0．133kPa），平均（14．91±2．86）mmHg。应用UBM进行检查，并根据结果进行房角宽度参数测量，比较LPI术前和术后2周、6个月和12个月房角开放距离（AOD）、小梁下-虹膜空间面积（TISA）和房角隐窝（ARA）参数。分别记录LPI术前、术后1h、2h、8h、24h、2周、6个月和12个月眼压变化情况。根据术后眼压将患者分为术后眼压≤21mmHg（1mmHg=0．133kPa）组（41眼）和术后眼压〉21mmHg组（17眼）。对影响LPI手术的因素进行多因素Logstic回归分析，探讨术前UBM测量房角宽度参数与LPI术后眼压变化的关系。结果2个组患者术前眼压、房角宽度各参数比较，差异均有统计学意义（均P〈0．01）。手术前后各组眼压变化的总体比较，差异有统计学意义（F=16．353，P〈0．01）。术后12例出现一过性眼压升高，药物控制眼压稳定后停药，随访1年均未出现眼压升高和视野损害。术后6～12个月，随访发现眼压异常5例。LPI术后2周、6个月和12个月眼压较术前明显降低，差异均有统计学意义（均P〈0．01）。UBM房角宽度参数较术前明显增加，差异均有统计学意义（均P〈0．01）。2个组患者术前眼压、房角宽度各参数比较，差异均有统计学意义（均P〈0．01）。多因素Logstlc回归分析发现，术前房角宽度参数ARA750[优势比（OR）=0．75，P〈0．05]是术后眼压的影响因素，而年龄、术前眼压、AOD和TISA均与LPI术后眼压无关（均P〉0．05）。结
Objective To evaluate the relationship between anterior chamber angle and intraocular pressure （IOP） after laser peripheral iridotomy （LPI） treatment. Methods A retrospective cases control study was adopted. Fifty-eight patients （58 eyes） who were diagnosed as primary angle closure （PAC） were included in this study. Ultrasound biomicroscopy （UBM） parameters in angle opening distance （AOD） , trabecular iris area （TISA） and angle recess area （ARA） examination were performed before LPI. The changes of intraocular pressure （IOP） were compared between different time-points （before and 1 hour,2 hours,8 hours ,24 hours ,2 weeks ,6 months and 12 months after LPI）. The patients were divided into IOP≤21 mmHg group （41 eyes） and IOP〉21 mmHg group （17 eyes） after LPI. Relationship between anterior chamber angle and IOP after LPI treatment was explored. This study was approved by Ethic Committee of the Henan Eye Institute and informed consent was obtained from each patient. Results The IOPs were increased in 1 hour,2 hours after LPI and lowered in 2 weeks,6 months,12 months after LPI compared with IOP before LPI,with significant differences between them （all at P〈0.01 ）. Twelve patients suffered transient elevated IOP and recovered by self-healing or treatment, lOP of 4 patients were elevated after 6 months to 1 year follow-up. The lOPs in 2 weeks,6 months and 12 months after LPI were lowered compared with lOP before LPI, with significant differences between them （ all at P〈0. O1 ）. The UBM parameters were significantly increased in 2 weeks,6 months, 12 months after LPI in comparison with lOP before IPL （all at P〈0.01 ）. lOP and UBM parameters values were significantly different between IOP〉21 mmHg group and ≤21 mmHg group after LPI. Regression analysis indicated that ARA750 （OR=0. 75 ,P〈0.05） was correlated to the lOP after LPI rather than lOP before operation, AOD and TISA （P〉0.05）. Conclusions ARA750 value is correlated with the IOP varia
作者
刘茜
董仰曾
李海军
王应飞
黄亚琳
董良
刘长庚
Liu Qian, Dong Yangzeng, Li Haijun, Wang Yingfei, Huang Yalin, Dong Liang, Liu Changgeng(Henan Eye Institute, Henan Eye Hospital, Henan Provincial People ＇s Hospital, Zhengzhou University People ＇s Hospital, Zhengzhou 450003, Chin)
出处
《中华实验眼科杂志》
CAS
CSCD
北大核心
2018年第4期289-293,共5页
Chinese Journal Of Experimental Ophthalmology
基金
国家自然科学基金项目（U1404812）
