超声生物显微镜量化观察超声乳化白内障吸除人工晶状体植入术后前房角的改变

目的　探讨超声乳化白内障吸除折叠式人工晶状体植入术后术眼前房角结构的改变。方法　对 4 6例 (5 0只眼 )老年性白内障患者行小切口超声乳化白内障吸除折叠式人工晶状体植入术 ,分别于术前和术后 1个月使用超声生物显微镜量化测量前房深度和前房角宽度。结果　全部患者术后 1个月前房深度明显增大 (P <0 0 1) ;5 0 0 μm处小梁虹膜夹角 (TIA5 0 0 )、2 5 0 μm和 5 0 0 μm处前房角开放距离 (AOD2 5 0、AOD5 0 0 )与术前比较均显著增大 (均P <0 0 1) ,TIA5 0 0平均比值 (术后TIA5 0 0 /术前TIA5 0 0 )为 1 6 5 (1 12～ 4 91) ,AOD2 5 0平均比值 (术后AOD2 5 0 /术前AOD2 5 0 )为1 81(1 0 6～ 2 6 7) ,AOD5 0 0平均比值 (术后AOD5 0 0 /术前AOD5 0 0 )为 1 6 5 (1 0 1～ 2 76 ) ,均与术前值呈显著负相关 (均P <0 0 1)。结论　超声乳化白内障吸除折叠式人工晶状体植入术可显著增大老年性白内障患者的前房角宽度 ;术前前房角越窄 ,术后前房角的变化程度越大。

A quantitative study of anterior chamber angle with ultrasound biomicroscopy after cataract surgery with phacoemulsification and foldable intraocular lenses implantation

OBJECTIVE: To study the changes in anterior chamber angle after phacoemulsification and foldable IOL implantation with ultrasound biomicroscopy. METHODS: Small-incision phacoemulsification and foldable IOL implantation were performed in 50 eyes of 46 senior patients, and the changes of anterior chamber angle were determined quantitatively by using ultrasound biomicroscopy before and one month after the surgery. RESULTS: In all patients, the angle was widened significantly one month after surgery (P < 0.01). The measurements of TIA500 (trabecular-iris angle at 500 micro m from the scleral spur), AOD250 (angle-opening distance at 250 micro m from the scleral spur) and AOD500 (angle-opening distance at 500 micro m from the scleral spur) increased significantly after the operation (P < 0.01). The mean post/pre-operative TIA500 ratio, AOD250 ratio and AOD500 ratio were 1.65 (1.12 - 4.91), 1.81 (1.06 - 2.67) and 1.65 (1.01 - 2.76), respectively. A significant negative correlation existed between preoperative and postoperative data. CONCLUSION: Small-incision cataract surgery deepens the anterior chamber and widens anterior chamber angle significantly in senior patients. The narrower the preoperative angle, the higher ratio of post/preoperative ratio found.