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1.
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。  相似文献   

2.
目的探讨原发性闭角型青光眼行复合式小梁切除术后眼前节结构的改变。方法选择原发性闭角型青光眼病例30例(30只眼),正常人对照组30例(30只眼),利用超声生物显微镜(UBM)检测所有眼的眼前节,青光眼患者在术前1天和术后1个月、6个月、2年进行检查。结果青光眼患者术前、术后各参数分别与对照组比较,差异均有统计学意义,术后较术前房角开放程度增加,前房深度其他参数无改变。结论原发性闭角型青光眼行复合式小梁切除术可以部分改变眼前节形态。  相似文献   

3.
目的探讨氩激光巩膜突光凝术治疗原发性开角型青光眼的疗效。方法应用氩激光巩膜突光凝术对原发性开角型青光眼患者36例67只眼进行了治疗。结果术后观察2年,眼压下降幅度与术前比较有显著性(P<0.001),且未见严重的并发症发生,其中21只眼已停用了降眼压药物。结论氩激光巩膜突光凝术治疗原发性开角型青光眼是一种有效方法。  相似文献   

4.
两类青光眼眼前节结构在超声生物显微镜下的表现   总被引:5,自引:1,他引:4  
目的:比较超声生物显微镜(ultrasound biomicroscopy,UBM)检查下慢性闭角型青光眼与原发性开角型青光眼前节各项指标的差异,探讨UBM在鉴别此两种类型青光眼的作用。方法:应用UBM测量已确诊的慢性闭角型青光眼13例25例,原发性开角型青光眼11例22眼的眼前节各参数,进行统计学分析,结果:慢性闭角型青光眼在前房深度,房角开放距离。巩膜睫状体夹角,小梁睫状体距离,小梁虹膜夹角上  相似文献   

5.
马瑞  刘伟  季建 《眼科新进展》2012,32(11):1058-1060
目的 通过超声生物显微镜评估白内障超声乳化联合人工晶状体植入术对药物可以控制的原发性闭角型青光眼患者眼前节结构的影响.方法 收集药物可以控制的原发性闭角型青光眼合并白内障患者30例(30眼),所有患者均自愿接受白内障超声乳化联合人工晶状体植入术.分别于术前及术后1个月、6个月行超声生物显微镜检查,通过测量前房深度、距离巩膜突500 μm的房角开放距离和小梁睫状突距离来观察前房结构的变化.结果 患者术前及术后1个月、6个月的前房深度分别为(1.781±0.260) mm、(3.249±0.741) mm、(3.473±0.196) mm,术后1个月和6个月患者的前房深度均较术前明显加深(均为P <0.001).术后上方、颞侧、鼻侧和下方4个象限距离巩膜突500 μm的房角开放距离较术前都有显著增加(均为P<0.001),分别平均增加0.114 mm、0.147 mm、0.149 mm和0.110 mm;4个象限的小梁睫状突距离均较术前显著增加(均为P<0.001),分别平均增加0.087 mm、0.142 mm、0.094 mm和0.121 mm.4个象限的距离巩膜突500μm的房角开放距离与小梁睫状突距离均呈显著正相关(均为P< 0.05).结论 对于药物可以控制的原发性闭角型青光眼,白内障手术可使中央前房加深,前房角增宽,睫状突位置后移.  相似文献   

6.
超声生物显微镜在原发性闭角型青光眼中的应用进展   总被引:1,自引:0,他引:1  
超声生物显微镜(u ltrasound b iom icroscopy,UBM)是一种高频超声波成像技术,对活体眼的眼前节结构进行实时观察、测量,可提供高清晰的眼前节图像。本文是对UBM在原发性闭角型青光眼病因、发病机制、诊断尤其是在对各种青光眼手术治疗效果评价中的应用进展进行综述。  相似文献   

7.
原发性先天性青光眼眼前段活体结构观察   总被引:4,自引:0,他引:4  
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。  相似文献   

8.
小梁切除术改良制做巩膜瓣的体会   总被引:1,自引:0,他引:1  
我院自1998年以来,在青光眼小梁切除术中,采用一次性向上弯曲的新月型隧道刀制做巩膜瓣18例24眼,其效果优于现行手术方法,现报告如下: 资料与方法:本组18例,均为住院病人,其中男6例,女12例,年龄41~73岁。原发性闭角型青光眼14例18眼;慢性闭角型青光眼4例6眼。常规术前准备,球后及瞬目麻醉,开睑,固定上直肌,以穹窿为基底做结膜瓣,用隧道刀之侧刃,距角膜缘4mm,水平切开巩膜的1/3~1/2厚度,切口宽3mm(根据术前眼压的高低选择巩膜瓣的厚薄及大小),隧道刀由此向前进行板层分离,一直…  相似文献   

9.
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.  相似文献   

10.
深层巩膜切除联合胶原物植入(deepscle-rectomywithcollagenimplant,DSCI)是近年开展的一种非穿透性抗青光眼手术,为探讨该手术降低眼压的机制,作者在DSCI术后1个月用超声生物显微镜进行了观察。病例选择:9例(9眼)予以抗青光眼药物治疗不能控制的开角型青光眼,男4例,女5例,平均年龄70.3±12.3岁(49~80岁),其中原发性开角型青光眼6眼,囊性青光眼2眼,人工’晶体性青光眼1眼。手术方法:球后麻醉,从上穹窿部切开球结膜后,做约4/10巩膜厚的smmXsmm巩膜瓣,在巩膜床上再做一三角形深层巩膜瓣并将其切除。Schlemm氏管…  相似文献   

11.
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.  相似文献   

12.
人眼睫状体在调节中形态与位置的动态变化   总被引:2,自引:0,他引:2  
Ma J  Chen XM 《中华眼科杂志》2004,40(9):590-596
目的了解健康活体人眼在自发视远视近调节中,睫状体形态和位置动态变化的特点。方法利用超声生物显微镜(UBM)的50MHz高频换能器,对68例正常人眼注视远、近不同视标时睫状体形态、位置的变化进行动态观测和统计学分析。结果(1)视近调节时,睫状体前部厚度、睫状突长度、睫状体总面积和环形肌面积增大,睫状突宽度及内尖成角、睫状突与小梁、虹膜、巩膜突的距离,以及其和虹膜、巩膜的夹角减小,前房角开放程度变小。而睫状体后部厚度、纵行肌面积、巩膜虹膜夹角以及小梁虹膜夹角的差异无显著意义。(2)形态各参数间的变化相辅相成、高度一致,位置各参数亦然,但形态与位置之间关系无显著意义。结论人眼视近调节时,睫状体各部肌纤维协调收缩,尤其是环形肌收缩,使睫状突变得尖而细长,睫状体向前向内移动,松弛悬韧带,支持Helmholtz的调节松弛学说。UBM可实时观测人眼调节时睫状体各部分形态和位置等的变化情况。  相似文献   

13.
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.  相似文献   

14.
PURPOSE: To evaluate qualitatively and quantitatively ultrasound biomicroscopic (UBM) features of the anterior segment in eyes with primary congenital glaucoma. METHODS: UBM of 45 eyes of patients with primary congenital glaucoma (39 previously operated and 6 unoperated eyes) and 28 control eyes were included in this study. UBM parameters were correlated with ocular biometry. Iris thickness, ciliary body thickness, ciliary body-lens distance, posterior chamber depth, and anterior chamber angle were measured and compared with control eyes. Other features of the anterior segment were qualitatively evaluated. RESULTS: A thin, stretched-out ciliary body and abnormal tissue at the iridocorneal angle were features seen in 90% of UBM scans. Iris thickness and stretched zonules correlated with the axial length (r = -0.6 and 0.58, respectively; p = 0.04) but not with the mean corneal diameter. Abnormal insertion of the ciliary body to the posterior surface of the iris was noted in eight eyes (17%). CONCLUSIONS: The present study documents characteristic anterior segment dysplasia and ciliary body anomalies in patients with primary congenital glaucoma.  相似文献   

15.
PURPOSE: To describe a quantitative method for measuring the iridocorneal angle recess area, and, using this, to evaluate factors associated with appositional angle-closure during dark room provocative testing using ultrasound biomicroscopy (UBM). METHODS: All patients (178 patients, 178 eyes) with clinically narrow angles referred for UBM dark room provocative testing between September 1996 and March 1998 were enrolled in this study. Images of the inferior quadrant of the angle taken under standardized dark and light conditions were analyzed. The angle recess area (ARA) was defined as the triangular area demarcated by the anterior iris surface, corneal endothelium, and a line perpendicular to the corneal endothelium drawn from a point 750 microm anterior to the scleral spur to the iris surface. ARA, and acceleration and gamma-intercept of the linear regression analysis of the ARA were calculated. In the linear regression formula, y = ax + b, the acceleration a describes the rate at which the angle widens from the scleral spur; the y-intercept b describes the distance from the scleral spur to the iris. RESULTS: Under dark conditions, the angles in 99 patients (55.6%) showed evidence of appositional angle-closure during testing. ARA (0.11 +/- 0.04 vs. 0.15 +/- 0.05 mm2, P < .0001, Student t-test), acceleration a (0.22 +/- 0.15 vs. 0.26 +/- 0.17, P = .068), and y-intercept b (66 +/- 46 vs. 92 +/- 47 microm, P = .0003) were smaller in eyes that were occluded. In the eyes that were not occluded, y-intercept b showed no significant difference between light and dark conditions (P = .1, paired t-test), while acceleration a did (P < .0001). In the eyes that were occluded, both decreased significantly under dark conditions (P < .0001). CONCLUSIONS The ARA linear regression formula provides useful quantitative information about angle recess anatomy. The more posterior the iris insertion on the ciliary face, the less likely the provocative test will be positive.  相似文献   

16.
Anterior segment imaging is a rapidly advancing field of ophthalmology. New imaging modalities, such as rotating Scheimpflug imaging (Pentacam-Scheimpflug) and anterior segment optical coherence tomography (Visante OCT and Slit-Lamp OCT), have recently become commercially available. These new modalities supplement the more established imaging devices of Orbscan scanning slit topography and ultrasound biomicroscopy (UBM). All devices promise quantitative information and qualitative imaging of the cornea and anterior chamber. They provide a quantitative angle estimation by calculating the angle between the iris surface and the posterior corneal surface. Direct angle visualisation is possible with the OCT devices and UBM; they provide images of the scleral spur, ciliary body, ciliary sulcus and even canal of Schlemm in some eyes. Pentacam-Scheimpflug can measure net corneal power, a feature particularly useful for cataract patients having undergone previous corneal surgery. Anterior segment OCT can measure corneal flap depth following LASIK and anterior chamber width prior to phakic intraocular lens implantation. The arrival of the new imaging devices may herald the dawn of a new era for ophthalmic diagnosis, particularly in view of the ease and non-contact nature of examination.  相似文献   

17.
PURPOSE: To report quantitative changes in the anterior segment configuration after clear corneal incision phacoemulsification and foldable intraocular lens (IOL) implantation by means of ultrasound biomicroscopy (UBM). DESIGN: Prospective, nonrandomized, comparative (self-controlled) trial. PARTICIPANTS: Twenty-one eyes of 19 patients with senile or presenile cataracts and no other ocular illness. METHODS: Patients were examined with UBM before and 1 and 3 months after surgery. At each UBM examination, axial images of the anterior chamber and radial sections of the angle at the superior, lateral, inferior, and medial quadrants were obtained. MAIN OUTCOME MEASURES: Central anterior chamber depth (ACD), iris-lens contact distance, iris-lens angle (ILA), angle opening distance at points 250 (AOD250) and 500 microm (AOD500) from the scleral spur, trabecular-iris angle (TIA), iris thickness 500 microm from the scleral spur (IT), trabecular-ciliary process distance (TCPD), iris-ciliary process distance (ICPD), iris-zonule distance, iris-sclera angle (ISA), and ciliary process-sclera angle (CPSA). After surgery, central anterior chamber depth was also measured from the cornea to the IOL (ACD) and from the cornea to the pupillary plane (ACD2). Each variable was measured twice in different days by the same observer. RESULTS: The variables IT, TCPD, ICPD, IZD, and CPSA did not significantly change after surgery (P > 0.01). Central anterior chamber depth increased approximately 30% after surgery (approximately 850 microm; P < 0.001), by both measurement methods used (ACD x ACD and ACD x ACD2). Anterior chamber angle significantly increased, by approximately 50% of the initial value, by the three measurement methods used: AOD250 (P 相似文献   

18.
Wang T  Liu L  Li Z  Hu S  Yang W  Zhu X 《中华眼科杂志》1998,34(2):137-140
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。  相似文献   

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