超声生物显微镜在青光眼白内障联合手术中的应用

目的:利用超声生物显微镜(ultrasound biomicroscope,UBM)检查的结果来指导青光眼合并白内障患者术前手术方法的选择,观察患者术后房角及其相关结构的改变。方法:对合并白内障的原发性闭角型青光眼(primary angle closure glaucoma,PACG)患者30例(30眼)行小梁切除术联合白内障小切口手法碎核晶状体摘除及人工晶状体植入。术前及术后1mo常规行视力、裂隙灯、用UBM测量前房深度(anterior chamber distance,ACD)、小梁虹膜角(tra-becular iris angle,TIA)、房角开放距离500(angle opening dis-tance,AOD500)、小梁睫状体距离(trabecular ciliary proces-ses distance,TCPD)和虹膜厚度1(iris distance,ID1)的检查,同时记录眼压的变化并进行分析。结果:术后眼压较术前明显降低。ACD、TIA、AOD500、TCPD术前术后比较均有显著性差异(P<0.05)。ID1术前术后比较无显著性差异。结论:青光眼白内障联合手术可明显加深前房,增宽房角,重新开放小梁网。远期效果待于更多样本、更长时间的术后观察。

The use of ultrasound biomicroscopy in observation of anterior chamber angle structure after combined glaucoma and cataract surgery

AIM:To evaluate the use of ultrasound biomicros-cope (UBM) in operative treatment of glaucoma com-bined with cataract,and to observe on the anterior chamber angle and its related structure in the patients with primary angle-closure glaucoma (PACG) after operation.·METHODS:Combined MMF,intraocular lens (IOL) implantation and trabeculectomy were performed in 30 patients (30 eyes) with cataract and PACG. The changes of anterior chamber angle,anterior chamber distance were determined quantitatively by using UBM before and post operation 1 month. Trabecular iris angle (TIA),angle opening distance (AOD500),trabecular ciliary processes distance (TCPD) and iris distance (ID1) were measured. At the same time,the intraocular pressure (IOP) was also recorded. ·RESULTS:The IOP were obviously decreased after operation. There were significant differences between the preoperative and postoperative ACD,AOD500,TIA,TCPD (P<0.05). There was no statistical difference between the preoperative and postoperative ID1. ·CONCLUSION:Combined glaucoma and cataract sur-gery can deepen the anterior chamber and anterior chamber angle,and reopen trabecular meshwork. It contributes to control intraocular pressure better and reduce postoperative complications such as shallow anterior chamber. A larger study with longer follow-up is needed to determine its long-term clinical outcomes.