不同年龄健康人眼调节状态超声生物显微镜对比观察

目的 了解健康人眼在不同调节状态下,睫状体、晶状体形态位置动态变化的特点及其与年龄变化的关系.方法 利用超声生物显微镜(UBM),对70名不同年龄组正常人眼注视远、近不同距离视标时睫状体、晶状体形态位置的变化进行动态观察和统计学分析.结果 (1)视远时,睫状体厚度平均值(1.08±0.15)mm,睫状突长度平均值(1.92±0.29)mm, 睫状突宽度平均值(0.74±0.11)mm,晶状体中央厚度平均值(3.46±0.45)mm;视近时,睫状体厚度平均值(1.16±0.17)mm,睫状突长度平均值(2.05±0.27)mm,睫状突宽度平均值(0.67±0.09)mm,晶状体中央厚度平均值(3.57±0.42)mm;视近与视远相比,睫状体前部厚度增加、睫状突长度增加,睫状突宽度变小,晶状体中央厚度增加,各参数经独立样本t检验,P值均<0.05,差异有统计学意义.(2)随年龄增加,视远、视近时各形态参数与年龄间经Pearson检验存在相关性.结论 人眼视近时,睫状体各部肌纤维协调收缩,使睫状突变长变尖,睫状体向前向内移动,松弛悬韧带,晶状体借自身弹性变凸,中央厚度变厚,前后径增加.同时,随年龄增长,人眼调节力逐渐下降.支持Helmholtz的调节松弛学说.利用UBM可实时观察人眼调节时眼前节结构形态和位置的变化情况.     

环核苷酸与房水动力过程

小梁、睫状突供养血管和Schlemm管均有肾上腺素能神经分布。人眼睫状突、睫状体和虹膜的β受体各占虹膜睫状体β受体的1/3,小梁也有β受体分布。睫状上皮可能存在密度较高的多巴胺受体和ANP受体。正常房水中的肾上腺素,去甲肾上腺素、前列腺素、ANP和12(R)-HETE,可能是调节眼压的局部因素。cAMP和cGMP可能通过cAMP信号系统和IP_3-Ca~(2+)信号系统的相互作用,共同参与调节房水动力过程。依赖cAMP的蛋白激酶被激活后,能增强vimentin微丝等细胞骨架蛋白磷酸化,促进睫状体通道开放,调节房水分泌速率和流出易度。     

原发性闭角型青光眼的超声生物测量研究

目的 应用A型眼科超声和超声生物显微镜(ultrasound biomicroscope,UBM)研究原发性闭角型青光眼(primary angle-closure glaucoma,PACG)不同瞳孔直径下眼前节和后房结构的解剖特征.方法 正常对照组24例(48眼)及PACG组24例(48眼)按照检查时瞳孔直径(d)分为以下3组:d ＜2.5 mm组,2.5 mm≤d≤4.0 mm组,d＞4.0 mm组,进行眼轴测量和UBM检查.眼轴长度采用STORZ-A型眼科超声诊断仪测量,眼前节各项参数采用Zeiss-Humphrey-840型UBM检查.结果 PACG眼较正常眼前房浅,眼轴短,小梁网虹膜夹角变小,房角开放距离缩短,睫状突高度减小,巩膜外侧面与虹膜长轴的夹角、与睫状突夹角减小.PACG眼的角膜厚度较正常眼增厚,分别为(584.208±78.210) μm、(577.583±39.681)μm,但差异无统计学意义(P＞0.05).反映瞳孔阻滞的参数虹膜晶状体接触距离差异无统计学意义(P＞0.05).PACG眼与具有正常瞳孔直径的眼相比,瞳孔直径越大,小梁网虹膜夹角越小,根部虹膜越厚,虹膜晶状体接触距离越小,而正常眼的根部虹膜厚度、小梁网虹膜夹角、虹膜晶状体接触距离与瞳孔直径无相关性.结论 PACG眼与正常眼解剖结构在任何瞳孔直径下均不同.PACG眼随瞳孔直径增大,眼前节更为拥挤,睫状体旋前增加房角关闭可能.     

原发性急性闭角型青光眼小梁切除术前后眼前节超声生物显微镜测量比较

目的通过超声生物显微镜（UBM）眼前节测量了解急性闭角型青光眼行小梁切除术后眼前节组织空间结构变化。方法对20例（21只眼）急性闭角型青光眼患者,术前及术后3个月行UBM测量中央前房深度、房角开放距离、小梁网睫状突距离、虹膜厚度、虹膜晶状体接触距离。结果术前与术后比较,中央前房深度、小梁网睫状突距离、虹膜厚度无统计学差异（P〉0．05）,房角开放距离、虹膜晶状体接触距离差异有统计学意义（P〈0．05）。结论急性闭角型青光眼患者行小梁切除术后,房角开放距离增加,瞳孔阻滞缓解,但睫状突前位没有改变。UBM是一种客观的、有效的随访工具。     

青少年眼调节与非调节状态下眼前节结构生物测量对比分析

目的 探讨小学生和中学生在调节和非调节状态下眼前节部分解剖结构的动态变化规律。方法 横断面研究。采用超生生物显微镜（UBM）检测福州市54例小学生及55例中学生在调节和非调节状态下的睫状体、虹膜及房角等位置相关数据,数据采用配对t检验和独立样本t检验进行分析。结果 非调节状态下小学生组各指标数值如下：睫状突长度（CPD）值（160.53±17.78）μm,睫状突宽度（CT）值（90.01±34.30）μm,虹膜睫状体距离（ICPD）值（23.11±3.33）μm,虹膜厚度（IT）1值（35.95±6.60）μm,IT2值（52.81±9.94）μm,小梁睫状体距离（TCPD）值（151.27±23.11）μm,巩膜外侧面与虹膜长轴的夹角θ3值（39.23±7.46）°,虹膜外侧面与睫状突的夹角θ4值（56.02±6.75）°;调节状态下相应指标分别为：（187.62±15.44）μm、（74.23±19.87）μm、（19.78±2.69）μm、（30.34±5.83）μm、（47.11±6.71）μm、（131.55±20.02）μm、（31.68±5.14）°、（50.39±4.89）°。调节与非调节状态下比较,差异均有统计学意义（t=8.45、2.93、5.72、4.68、3.49、4.74、6.12、4.96,P＜0.05）。中学生组非调节状态下以上各指标分别为：（214.64±15.25）μm、（99.13±17.80）μm、（27.92±9.00）μm、（40.72±6.43）μm、（56.57±9.13）μm、（176.82±28.06）μm、（43.73±6.93）°、（60.15±10.48）°;调节状态下分别为：（271.38±11.96）μm、（93.27±10.42）μm、（21.66±7.54）μm、（35.68±4.37）μm、（50.17±6.49）μm、（136.41±19.35）μm、（39.51±5.28）°、（53.68±9.12）°。调节与非调节状态下各参数比较,差异均有统计学意义（t=20.91、2.03、3.81、4.63、4.08、8.47、3.46、3.33,P＜0.05）。同样在调节状态下,小学生组和中学生组所有睫状体相关指标之间差异都存在统计学意义（t=30.95、6.10、4.47、5.29、2.37、7.70、2.32、6.98,P＜0.05）。结论 人眼进行视近调节时,睫状体的变化最为显著,出现各部肌纤维尤其是环形肌协调收缩,并向前向内移动,使晶状体悬韧带松弛,实现眼屈光力的增加;且年龄越小,调节力越强。     

原发性前房角关闭眼激光周边虹膜切开术后前房角形态学变化

目的 定量检测和评价原发性前房角关闭(PAC)眼行激光周边虹膜切开(LPI)术后前房角形态学变化.方法 临床病例系列研究.对入选的31例(54只眼)PAC患者于LPI术前、术后2周、6及12个月,进行眼科常规检查,定量检测超声活体显微镜(UBM)图像中前房角的各项参数.各随访时间点的UBM参数比较采用重复测量的方差分析,巩膜突前750μm与500 μm处各参数的比较采用配对t检验.结果 LPI术后前房深度较术前加深0.10 mm,但差异并无统计学意义(F=3.50,P＞0.05).LPI术前,巩膜突前750 μm处,前房角开放距离(66.2±51.6) μm,小梁网与虹膜间夹角5.0°±3.5°,前房角隐窝面积(0.025±0.017)mm2,小梁网与睫状突距离(571.0±97.2) μm;LPI术后2周、6及12个月,巩膜突前750 μm处,前房角开放距离分别为(165.0±70.3)、(185.8±68.5)及(196.1±77.7)μm,小梁网与虹膜间夹角分别为(11.9±4.9)、(13.3±4.8)及14.0°±5.4°,前房角隐窝面积分别为(0.058±0.024)、(0.065±0.023)及(0.068±0.026)mm2,小梁网与睫状突间距离分别为(647.1±113.0)、(701.8±93.4)及(670.1±95.4) μm,均较LPI术前增加,差异均有统计学意义(前房角开放距离:F =92.60,小梁网与虹膜间夹角:F=92.60,前房角隐窝面积:F=92.60,小梁网与睫状突间距离:F =34.00;P ＜0.05).术后前房角开放距离、小梁网与虹膜间夹角及前房角隐窝面积均较术前增加1倍以上.巩膜突前750 μm处检测参数的增加幅度均较巩膜突前500 μm处大(前房角开放距离:t=5.90,P＜0.05;小梁网与虹膜间夹角:t=2.70,P＜0.05;前房角隐窝面积:t=2.00;P =0.05).结论 LPI能显著增宽PAC眼的周边前房角,且随访观察1年期间前房角仍开放.巩膜突前750 μm处的参数比500μm处参数对评价周边前房角形态变化更为敏感.     

超声生物显微镜对慢性闭角型青光眼合并白内障手术疗效的评价研究

目的探讨超声生物显微镜(ultrasound biomicroscopy,UBM)对慢性闭角型青光眼合并白内障手术疗效的评价。方法选择2010年5月至2011年11月在我院治疗的慢性闭角型青光眼合并白内障患者63例(88眼)作为研究对象,所有患者均接受白内障超声乳化及人工晶状体植入术,分别在术前1个月及术后1个月对患眼进行UBM检查,并观察患眼随访末期的矫正视力。结果 UBM检查结果显示,术前房角开放距离、小梁网睫状突距离、前房深度、小梁虹膜夹角、巩膜睫状突夹角分别为(0.23±0.11)mm、(0.69±0.22)mm、(2.20±0.39)mm、(22.49±10.98)°、(44.16±13.46)°,术后分别为(0.53±0.12)mm、(0.84±0.23)mm、(3.12±0.33)mm、(35.58±11.23)°、(49.01±13.27)°,术后均明显大于术前,差异均有统计学意义(均为P<0.05);术后虹膜厚度、虹膜晶状体夹角、虹膜悬韧带距离与术前比较,差异均无统计学意义(均为P>0.05)。术后患者矫正视力均明显提高,与术前比较,差异有统计学意义(P<0.05)。结论 UBM能够对慢性闭角型青光眼合并白内障患者的手术治疗效果进行有效评价。     

浅谈《调节机制新概念:基于超焦距-微变焦的人眼光学系统》

调节是指人眼在看清近处物体时晶状体屈光能力发生改变的现象.《调节机制新概念:基于超焦距-微变焦的人眼光学系统》一文引入了摄影镜头的超焦距概念,并基于超焦距的特点,提出人眼实际上存在3个超焦距,即远超焦距、近超焦距和调节超焦距.在调节活动中,睫状肌的收缩是推压悬韧带、悬韧带推压晶状体赤道部,还是使拉紧的悬韧带松弛、晶状体前突,这对于理解《调节机制新概念:基于超焦距-微变焦的人眼光学系统》是至关重要的.从解剖结构上来讲,在调节活动中,睫状肌的收缩推压悬韧带、纤弱的悬韧带推压晶状体赤道部的可能性较小,而使拉紧的悬韧带松弛、晶状体前突的可能性更大.笔者认为,睫状肌的收缩在调节活动中具有主动性的启动作用,因此当眼从视近转向视远时,睫状肌(收缩的环形肌)将会迅即恢复到松弛常态,晶状体受悬韧带的牵拉而恢复到原来的相对扁平状,并非被动性压迫,因为晶状体并不是调节活动的启动体,只不过是一个承载体而已.人眼的调节活动是非常复杂的,在整个调节活动中,不仅有睫状肌的收缩、晶状体屈光能力的增加,也伴随着瞳孔的缩小和集合的发生,因此任何机械、单一的模式者很难解释人眼复杂的调节活动.     

MMP-1、TIMP-1及TIMP-2在正常人眼前段组织的表达

目的观察正常人眼前段组织中基质金属蛋白酶1(MMP-1)、基质金属蛋白酶抑制剂1(TIMP-1)和TIMP-2的表达,探讨正常生理状态下MMP及TIMP在小梁网房水流出及葡萄膜巩膜房水流出通道中的作用。方法应用酶免疫组织化学技术,检测正常人眼前段组织中MMP-1、TIMP-1和TIMP-2的定位。阳性结果应用图像分析系统进行定量分析。结果免疫组织化学结果显示MMP-1和TIMP-2广泛分布于人眼的虹膜、睫状体(包括睫状突上皮细胞和睫状肌)、小梁网、视网膜色素上皮(RPE)层、脉络膜及巩膜,TIMP-1分布于除小梁网外的其余组织。结论MMP-1、TIMP-2广泛分布于人眼小梁网及葡萄膜巩膜房水流出通道、RPE、脉络膜,TIMP-1广泛分布于人眼葡萄膜巩膜房水流出通道及RPE、脉络膜,对维持人眼正常房水流出及维持RPE、脉络膜功能可能具有一定作用。     

应用超声生物显微镜研究睫状肌麻痹剂对眼前节结构的影响

目的应用超声生物显微镜观察局部应用睫状肌麻痹剂前、后眼前节形态结构的改变及其与眼压的关系,同时对睫状体厚度、睫状体晶体赤道部距离进行观察。方法以４８只正常眼为研究对象,在局部应用２％后马托品前、后分别进行眼前节结构的超声生物显微镜定量测定,并测量眼压。对其结果进行统计学分析。结果用药后在反映房角改变的参数中,小梁虹膜夹角减小,房角开放距离２５０减小,虹膜厚度１增厚,前房加深,虹膜晶体接触距离缩短,差异均有显著性（Ｐ＜０．０５）;在反映睫状体改变的参数中,睫状体和睫状突的厚度减小,巩膜睫状体夹角增大,虹膜悬韧带距离减小,睫状体晶体距离增大,差异有显著性（Ｐ＜０．０５）。应用睫状肌麻痹剂后,眼压由２．３５±０．４６ｋＰａ（１ｋＰａ＝７．５ｍｍＨｇ）升高至２．４３±０．４７ｋＰａ,但差异无显著性（Ｐ＞０．０５）。结论局部应用睫状肌麻痹剂后,前房加深、房角变窄、睫状体变薄且向后运动、睫状体晶体距离增大。超声生物显微镜能动态观察眼前节结构的改变并行定量测定,在眼前节形态学研究中具有优越性。     

应用超声生物显微镜检查原发性婴幼儿型青光眼的眼前节形态特征

目的 了解原发性婴幼儿型青光眼在活体状态下的眼前节组织结构特点。方法 应用超声生物显微镜,以５０ｍＨＺ的超高频超声探关,对３８例（５８只眼）原发性婴幼儿型青光眼的眼前节结构进行测量和动态学检查。结果 ＰＩＧ患儿无论发病早晚、病情轻呈年龄大小,其最主要的病变特征是巩膜突与留心 角顶点的相对位置发生变化,３／４患眼的巩膜突位于房角顶点外侧或后外方,１／４患眼的巩膜突虹膜根部附着处平行,眼状突长度和厚度     

应用超声生物显微镜检测原发性婴幼儿型青光眼的眼前节形态特征

目的了解原发性婴幼儿型青光眼（ｐｒｉｍａｒｙｉｎｆａｎｔｉｌｅｇｌａｕｃｏｍａ,ＰＩＧ）在活体状态下的眼前节组织结构特点。方法应用超声生物显微镜（ｕｌｔｒａｓｏｕｎｄｂｉｏｍｉｃｒｏｓｃｏｐｙ,ＵＢＭ）,以５０ｍＨｚ的超高频超声探头,对３８例（５８只眼）原发性婴幼儿型青光眼的眼前节结构进行测量和动态学检查。结果ＰＩＧ患儿无论发病早晚、病情轻重或年龄大小,其最主要的病变特征是巩膜突与房角顶点的相对位置发生变化,３／４患眼的巩膜突位于房角顶点外侧或后外方,１／４患眼的巩膜突与虹膜根部附着处平行。睫状突长度和厚度均大于同龄正常儿童。睫状突向前、向内移位,部分与虹膜相贴。结论ＰＩＧ患儿的巩膜突与房角顶点相对位置的改变,提示巩膜突发育不良或虹膜附着点靠前,这是原发性婴幼儿型青光眼发病的病理基础。     

原发性先天性青光眼眼前段活体结构观察

目的:观察先天性青光眼的超声生物显微镜(UBM)图像特征并探讨先天性青光眼的发病机制。方法:采用高频、高分辨率的超声生物显微镜对6例先天性青光眼患者10只眼的房角、虹膜、睫状体等进行扫描和分析,并与7例正常人或无相关疾病患者的7只眼进行比较。结果:超声生物显微镜检查显示出原发性先天性青光眼的房角、虹膜、睫状体及巩膜突发育不良,虹膜基质薄,睫状体细小,巩膜突解剖特征不明显。原发性先天性青光眼组的虹膜厚度及睫状体大小的测量和统计学比较均明显小于正常对照组。结论:超声生物显微镜可以观察到常规眼科检查观察不到的部位,如睫状体、房角隐窝、虹膜后表面等等。原发性先天性青光眼具有虹膜基质薄、睫状体细小、巩膜突解剖特征不明显等特征,提示原发性先天性青光眼除了房角发育异常外,尚合并存在虹膜、睫状体巩膜突发育不良。其中虹膜、睫状体发育不良可能是先天性青光眼相对比较重要的发病机制。眼科学报1998;14:83—86。     

Long ciliary processes with no ciliary sulcus and appositional angle closure assessed by ultrasound biomicroscopy

PURPOSE: Nonpupil block mechanisms and appositional angle closure after laser iridotomy (LI) have been reported as common findings in Asians. We evaluated the presence of these findings in a cohort of Brazilian patients using ultrasound biomicroscopy (UBM). METHODS: This observational case-control study included 22 open angle eyes and 31 eyes with occludable angles on gonioscopy (defined by 2 examiners). UBM radial scans through a typical ciliary process were obtained in both light and dark conditions, at 6 and 12-o'clock positions. Long ciliary processes with no ciliary sulcus were determined on the basis of a reference line drawn perpendicular to the iris plane passing through a point located 750 mum from scleral spur. Trabecular ciliary processes distance was measured on 6-o'clock UBM images. RESULTS: After LI, 52% of occludable angle eyes had appositional angle closure in both 6 and 12-o'clock UBM images. We also observed this finding in 14% and 23% of the control eyes (in 6 and 12-o'clock UBM images, respectively). A long ciliary process with no ciliary sulcus was observed in 61% of occludable angle eyes, and also in 32% of control eyes (6-o'clock UBM images). Control eyes had longer trabecular ciliary processes distance than occludable angle eyes (P<0.001). CONCLUSIONS: The UBM finding of long ciliary processes associated with the absence of ciliary sulcus is not necessarily related to an anterior positioning of the ciliary processes. Whether UBM appositional angle closure after LI is associated with further angle closure process and/or poor intra-ocular pressure control remains to be evaluated.     

应用超声生物显微镜检查及诊断眼部睫状体脱离

目的探讨眼部睫状体脱离的形态学改变及其临床意义。方法应用超声生物显微镜（ｕｌｔｒａｓｏｕｎｄｂｉｏｍｉｃｒｏｓｃｏｐｙ,ＵＢＭ）对１７３例睫状体脱离的患眼与健眼的形态进行观察,并对其测量的相关参数进行统计学分析。结果所有睫状体脱离眼均为３６０°全周脱离,而非某一象限的脱离。ＵＢＭ探查睫状体脱离的特征性表现：巩膜与睫状体间存在无回声区,睫状突位置前移、前旋,睫状体平坦部向玻璃体中轴部位移动,部分患者可见睫状体平坦部呈层间分离。部分患者可显示虹膜、睫状体与巩膜附着点完全脱离,形成睫状体离断,离断的范围可为眼球的某一象限而非眼球全周,致使前房与睫状体上腔之间形成完全沟通的瘘口。脱离眼的前房深度（２１１５±５８９）μｍ较未脱离眼的前房深度（２７３６±４４１）μｍ浅（ｔ＝４．４９,Ｐ＜０．００１）,前房变浅的原因是睫状突前移、前旋导致虹膜根部膨隆。结论应用ＵＢＭ检查可以明确地诊断睫状体脱离,且不受屈光间质条件的限制,将为临床治疗提供可靠的依据。     

Observation of physiological change in the human ciliary body using an ultrasound biomicroscope during accommodation]

PURPOSE: To evaluate changes in the ciliary body during accommodation using an ultrasound biomicroscope (UBM). SUBJECTS AND METHODS: Eleven healthy persons, aged from 24 to 33 years, served as subjects. They were asked to lie in the supine position and to fixate a target placed on the ceiling 2 m above with the left eye. A concave lens with the power of -6 to -8 diopters was then placed before the fixating left eye. The thickness of the ciliary body in the right eye was measured by UBM in the nonaccommodative and accommodative states. FINDINGS: The anterior chamber in the right eye became significantly shallow during accommodation. The thickness of the ciliary body significantly increased during accommodation at 0.5 mm and 1.0 mm posterior to the scleral spur. It significantly decreased at 2.0 mm, 2.5 mm and 3.0 mm posterior to the scleral spur. CONCLUSION: During induced accommodation in the left eye, the anterior portion of the ciliary body in the right eye increased and the posterior portion decreased in thickness. The findings imply that the circular ciliary muscles are mainly involved in accommodation and not the longitudinal muscles.     

Light and electron microscopy of the anterior chamber angle structures following surgical disinsertion of the ciliary muscle in the cynomolgus monkey.

Light and electron microscopic studies were done on 11 cynomolgus monkey eyes which had undergone total iris removal followed by surgical disinsertion of the ciliary muscle from the scleral spur 4.7 to 14.4 months earlier. Anterior chamber perfusion to measure gross outflow facility had been performed one to nine times postoperatively. Over most of the circumference in most eyes (1) the ciliary muscle had been retrodisplaced from the scleral spur and had reattached to the sclera more posteriorly; (2) ciliary muscle, trabecular meshwork, and Schlemm's canal appeared normal. A cyclodialysis cleft was never seen. Fixation of some eyes in the in vivo and in vitro presence of pilocarpine demonstrated the contractibility of the retrodisplaced muscle. In isolated areas where the ciliary body had been surgically cut, scar tissue of varying thickness connected scleral spur, sclera, ciliary body, zonule, and lens capsule, but did not infiltrate trabecular meshwork or Schlemm's canal. In such sectors, plasma cell-like cells replaced trabecular endothelial cells and were also present in the scar tissue, ciliary muscle, and surrounding vessel walls in the scar and sclera. In sectors of two eyes, a previously existing trabecular operculum extended posteriorly and completely covered the meshwork. The meshwork in these sectors was poorly perfused by aqueous humor, and electron-dense deposits were present beneath the inner wall of Schlemm's canal. Four totally iridectomized and two unoperated eyes from these monkeys were also examined; ciliary muscle, trabecular meshwork, and Schlemm's canal appeared normal in all, despite the numerous anterior chamber perfusions.     

Anterior segment changes during accommodation in eyes with a monofocal intraocular lens: high-frequency ultrasound study

PURPOSE: To analyze anterior segment structure changes during accommodative stimuli after monofocal intraocular lens (IOL) implantation using 2 ultrasound biomicroscopy (UBM) systems. SETTING: Department of Ophthalmology, University of Verona, Verona, Italy. METHODS: Twenty-six eyes (23 patients) with 1 of 4 monofocal IOL types were studied. Five to 9 months postoperatively, the patients were examined by high-frequency UBM using the HiScan system (Optikon 2000 SpA) and UBM 840 system (Carl Zeiss Meditec). Anterior chamber depth (ACD), iris-zonule distance, anterior chamber angle (ACA), scleral-ciliary process angle, and iris-ciliary process angle were measured using both systems. The iris-ciliary process distance and scleral spur perpendicular-sulcus distance were measured with the UBM 840 system and the sulcus-sulcus distance and capsular bag-IOL position with respect to ciliary process apex, with the HiScan system. Two experienced examiners performed all measurements. RESULTS: All parameters except the horizontal iris-ciliary process distance and vertical ACA measured by the UBM 840 system and horizontal ACA by the HiScan system showed significant variation during accommodation. An anterior shift of the IOL-capsular bag ciliary processes--sulcus-zonular iris complex was observed. A simultaneous centripetal shift of ciliary bodies and processes, shown by a reduction in sulcus and capsular bag diameter, was also observed. CONCLUSION: Anterior segment structures demonstrated accommodative movement on UBM after implantation of standard monofocal IOLs.     

孔源性视网膜脱离行巩膜外环扎和巩膜外加压术对眼球结构和眼压的影响

目的：观察巩膜外环扎术和巩膜外环扎联合巩膜外加压术对孔源性视网膜脱离(rhegmatogenous retinal detachment,RRD)患者眼球结构和眼压的影响。

方法：选取2014-05/2017-05在我院住院行手术治疗的RRD患者240例240眼,其中接受巩膜外环扎术100眼(巩膜外环扎术组),接受巩膜外环扎联合巩膜外加压术140眼(联合组)。术前、术后2、4、12wk,检测眼压、角膜厚度、角膜水平和垂直曲率、前房深度、晶状体厚度、眼轴长度、睫状体厚度及小梁虹膜夹角度数。

结果：术后12wk,两组患者240眼均获得解剖复位。术后2wk,两组眼压、角膜厚度、角膜水平和垂直曲率、晶状体厚度、睫状体厚度均较术前显著增加,前房深度及小梁虹膜夹角度数均较术前明显减小,差异均有统计学意义(P<0.05)。两组患者术后视力均较术前改善,且术后2wk联合组视力明显优于巩膜外环扎术组,差异均有统计学意义(P<0.05)。

结论：巩膜外环扎术和巩膜外环扎联合巩膜外加压术对角膜、前房、房角、晶状体厚度及小梁虹膜夹角度数在早期均有显著影响,巩膜外环扎联合巩膜外加压术对眼压的影响时间长,应予以关注。