全景超声活体显微镜对超声乳化白内障吸除术后前房结构改变的临床观察

目的 利用全景超声活体显微镜观察超声乳化白内障吸除术后前房结构的改变.方法 对年龄相关性白内障患者行超声乳化白内障吸除术前后的前房结构进行活体测量.81例(102只眼)年龄相关性白内障患者行超声乳化白内障吸除联合折叠型人工晶状体植入术,分别于术前、术后2个月利用全景超声活体显微镜测量前房水平、垂直直径及前房深度;并对其中32例患者(36只眼)测量颞侧前房角宽度.采用配对t检验及两个独立样本的t检验对相应数据进行统计学分析.结果 大部分患者术前术后前房垂直直径大于水平直径;全部患者术后2个月水平前房直径与术前相比明显增大(t=7.10,P<0.01),并与术前呈显著正相关(r=0.801,P<0.01).前房深度与术前相比明显加深(t=39.97,P<0.01),术后2个月前房深度与术前的比值与术前深度呈显著负相关(r=-0.864,P<0.01).32例患者(36只眼)术后2个月颞侧房角500μm处前房角开放距离(AOD500)和小梁虹膜夹角(TIA 500)较术前均显著增大,且比值(术后AOD 500/术前AOD500、术后TIA500/术前TIA 500)均分别与术前旱显著负相关(r=-0.763,-0.791;P<0.01).结论 大部分患者前房垂直直径大于水平直径;年龄相关性白内障患者行超声乳化白内障吸除联合人工晶状体植入术后前房直径增加,虹膜膈后移,前房深度、房角宽度增加.

Study of anterior chamber configuration with panoramic ultrasound biomicroscopy after cataract surgery with phacoemulsification and foldable intraocular lenses implantation

OBJECTIVE: To study the changes in anterior chamber configuration after phacoemulsification and foldable intraocular lenses (IOL) implantation with panoramic ultrasound biomicroscopy (UBM). METHODS: A novel panoramic UBM was developed for anterior segment scanning. Small-incision phacoemulsification and foldable IOL implantation were performed in 102 eyes of 81 patients with age-related cataract. The anterior chamber diameter in horizontal meridian and vertical meridian and the anterior chamber depth (ACD) were measured by computer calipers before and two months after the surgery. The changes of the anterior chamber angle were measured in 36 eyes. RESULTS: Diameter of anterior chamber in vertical meridian was greater than that in horizontal meridian in most cases. In all patients, horizontal anterior chamber diameter was widened significantly two months after surgery (t = 7.10, P < 0.01), a significantly negative correlation existed between preoperative and postoperative data(r = 0.801, P < 0.01). The ACD was deepened ( t = 39.97, P < 0.01) . In 36 eyes, the anterior chamber angle was widened. CONCLUSIONS: Diameter of the anterior chamber in vertical meridian is greater than that in horizontal meridian in most cases. After phacoemulsification and foldable IOL implantation, UBM revealed that the anterior chamber diameter is increased and postoperative chamber diameter can be estimated by preoperative one. After the operation, the iris diaphragm shifts backward, the anterior chamber is deepened and anterior chamber angle is widened.