超声生物显微镜量化观察高度近视眼合并白内障超声乳化人工晶状体植入术后前房角的改变

目的利用UBM(ultrasound bio microscopy)对高度近视眼及其对照组正视眼白内障患者在超声乳化白内障吸除折叠式人工晶状体植入的术前、术后进行房角形态量化观察并比较分析,旨在探讨高度近视眼合并白内障手术的安全性。方法选取高度近视眼组和正视眼组做为其对照组,每组白内障的患者各30例(30只眼),采用透明角膜切口白内障超声乳化折叠式人工晶状体植入术,于术前、术后1、3个月用UBM测量前房深度(anteri-orchamber distance,ACD)、房角开放度(openangle,AA)、房角开放距离(angle opening distance,AOD)、小梁睫状体距离(trabecular-ciliary processes distance,TCPD)和虹膜睫状体距离(iris-ciliary processes distance,ICPD),同时记录眼压的变化并进行分析。结果对照组术前与术后1、3个月相比,ACD、AA、AOD500、TCPD、ICPD有显著性差异,术后1个月和术后3个月相比无显著性差异。术后眼压与术前相比有显著性差异。高度近视眼组术前与术后1、3个月相比各项测量指标有显著性差异,术后1个月和术后3个月相比无显著性差异。术后眼压与术前相比有显著性差异。高度近视眼与正视眼相比较,术前及术后除外ICPD,其它各项指标均存在显著性差异。结论高度近视眼合并白内障选择透明角膜切口超声乳化吸除折叠式人工晶状体植入术术后与术前相比前房明显加深,房角明显加宽,眼压也有一定程度的下降;与正视眼相比术前和术后的前房深度、房角宽度均大于后者,进一步证实了高度近视眼独特的前节结构,提示透明角膜切口超声乳化白内障吸除折叠式人工晶状体植入术安全有效。

Quantitative study of anterior chamber angle with ultrasound biomicroscopy after high myopia cataract surgery with phacoemulsification and foldable intraocular lenses implantation

Objective To explore the advantages of small-incision phacoemulsification and foldable IOL implantation for high myopia. Method Small-incision phacoemulsification and foldable IOL implantation were performed in 60 eyes of 60 patients, which was divided into two groups. The changes of anterior chamber angle , anterior chamber distance were determined quantitatively by using UBM(Ultrasound biomicroscopy) before and post-operation 1month,3month. At the same time, the intraocular pressure were also recorded. Results In all patients, the angle was widened significantly one month, three month after surgery.The measurements of ACD, AA, AOD500, TCPD, ICPD increased significantly after the operation.The intraocular pressure were also reduced to some extent after the operation. There were significant differences between two groups in ACD, AA, AOD500, TCPD except for ICPD before and after the surgery. Conclusion Small-incision phacoemulsification and foldable IOL implantation surgery deepens the anterior chamber and widens anterior chamber angle significantly in senile high myopic cataract patients, and it also reduces intraocular pressure to some extent after the operation, which indicates that small-incision phacoemulsification and foldable IOL implantation surgery is safe and effective for high myopia patients.