原发性房角关闭眼激光虹膜切除术后UBM测量参数比较

目的:比较激光虹膜切开术前后原发性房角关闭(primary angle closure,PAC)眼超声生物显微镜(ultrasound biomicroscopy,UBM)参数。方法:对46例74眼PAC患者进行了一项前瞻性临床试验。平均年龄58,04±11.33(24.0-82.0)岁。所有病例行完整的眼科检查,前房角镜A超生物测量和超声生物显微镜检查(Vu-max,SonomedInc.,NY,USA)及24-2标准无色差视野检查(SAP,Humphrey Visual Field Analyzer-II i,Carl Zeiss Meditec Inc.,Dublin,CA,USA)。使用配对t检验评估基准和随访的平均值之间的变化。结果:激光周边虹膜切除术(laser peripheral iridotomy,LPI)术后,平均房角从8.02±4.61(0.10-19.60)度增加到17.66±6.39(0.10-32.70)度(P=0.000),房角开放距离500(angle opening distance 500,AOD500)从0.11±0.06(0.01-0.30)mm增加到0.23±0.07(0.13-0.50)mm(P=0.000),平均虹膜厚度(iris thickness,IT)从0.58±0.11(0.33-0.99)mm下降到0.52±0.10(0.25-0.77)mm(P=0.000)。小梁睫状突距离,虹膜睫状突距离和睫状体厚度均未发现显著统计学差异。结论:LPI术后PAC的白种人眼睛的AOD500,虹膜晶体距离和前房角增加,IT和虹膜晶体高度减少。这说明LPI解除了瞳孔阻滞,加深了前房,扩大了房角,减少了虹膜前凸和增厚。

Comparison of ultrasound biomicroscopic parameters following laser iridotomy in eyes with primary angle closure

·AIM: To compare the ultrasound biomicroscopy（UBM） parameters before and after laser iridotomy in eyes with primary angle closure(PAC).·METHODS: A prospective clinical trial was carried out in 46 cases (74 eyes) with PAC included in the study. Mean age was 58.04±11.33 (range 24.0-82.0) years. Complete ophthalmic examination, gonioscopy A-scan biometry and UBM (Vu-max, Sonomed Inc., NY,USA) and Standard Achromatic Perimetry (SAP) using the 24-2 was performed (Humphrey Visual Field Analyzer-II I, Carl Zeiss Meditec Inc., Dublin, CA, USA) in all cases. Changes in mean values between baseline and follow-up were assessed using a paired Student's t test.·RESULTS: The mean anterior chamber angle increased from 8.02±4.61(0.10-19.60) degree to 17.66±6.39 (0.10-32.70) degree (P=0.000), angle opening distance 500(AOD 500) increased from 0.11±0.06 (0.01-0.30) to 0.23±0.07 (0.13-0.50) mm (P=0.000),mean iris thickness(IT) decreased from 0.58±0.11(0.33-0.99)mm to 0.52±0.10 (0.25-0.77)mm(P=0.000) after laser peripheral iridotomy (LPI). No statistically significant changes were found in trabecular-ciliary process distance (TCPD), iris-ciliary process distance (ICPD) and ciliary body thickness (CBT).·CONCLUSION: AOD 500, iridolenticular distance (ILT)and anterior chamber angle (ACA) increases, IT and iridolenticular height (ILH) decreases after LPI in Caucasian eyes with PAC. It means that LPI relieves the pupillary block, deepens the anterior chamber, widens the ACA, decreases the anterior bowing and thickening of the iris.