Pentacam系统监测散瞳对白内障患者手术前后前节参数的影响

目的 观察白内障患者手术前后散瞳对中央前房深度、前房容积、角膜前后表面Km和散光等眼前节参数的影响。 方法 选取第四军医大学唐都医院拟行白内障超声乳化联合人工晶状体(IOL)植入术患者22例(25眼),术前1~2 d及术后1~2 d予以复方托吡卡胺滴眼液术眼散瞳,散瞳前及散瞳后30 min使用Pentacam HR眼前节分析系统测量眼前节参数。 结果 术前,散瞳前后中央前房深度分别为(2.71±0.56)mm和(2.79±0.53)mm(t=-4.246;P< 0.001);术后,散瞳前后中央前房深度分别为(3.60±0.98)mm和(4.45±0.35)mm(t=-4.473;P< 0.001),前房容积分别为(146.9±37.1)mm³和(163.3±33.9)mm³(t=-3.633;P= 0.001)。 结论 复方托吡卡胺滴眼液散瞳后白内障手术前后中央前房深度及白内障术后前房容积的测量值较大,可能会引起IOL计算误差,应于小瞳下测量中央前房深度和前房容积。

Effects of mydriasis on anterior chamber parameters measured by a Pentacam before and after cataract surgery

Objective To observe the effect of mydriasis on center anterior chamber depth,anterior chamber volume,corneal surface keratometry and astigmatism before and after cataract surgery.Methods This study included 25 eyes of 22 patients diagnosed with cataract and indicated for phacoemulsification with intraocular lens (IOL) implantation at Tangdu Hospital,the Fourth Military Medical University.For each patient,anterior segment parameters were measured 1-2 days before and after surgery,respectively,using a Pentacam HR system under conditions of normal pupils and dilated pupils.Results The mean preoperative central anterior chamber depths were (2.71 ± 0.56) mm and (2.79 ±0.53) mm before and after mydriasis,respectively (t =-4.246;P ＜ 0.001).The mean postoperative central anterior chamber depths were (3.60 ± 0.98) mm and (4.45 ± 0.35) mm before and after mydriasis,respectively (t =-4.473;P ＜0.001).The mean postoperative anterior chamber volumes were (146.9 ± 37.1) mm3 and (163.3 ±33.9) mm3 before and after mydriasis,respectively (t =-3.633;P =0.001).Conclusions The central anterior chamber depths before and after cataract surgery and the anterior chamber volumes after cataract surgery increase after mydriasis,which may lead to errors in IOL calculation.In patients with cataracts,the central anterior chamber depths and anterior chamber volumes should be measured before mydriasis.