闭角型青光眼超声乳化白内障吸出术后人工晶状体稳定性研究

目的　应用超长扫描深度的谱域眼前节光学相干断层扫描（ultra-long scan depth spectral domain optical coherence tomography，UL-OCT）观察原发性闭角型青光眼（primary angle-closure glaucoma，PACG）术后人工晶状体（intraocular lens，IOL）的稳定性。方法　选取42例（42眼）PACG患者（PACG组）和40例（40眼）年龄、性别相匹配的年龄相关性白内障（age-related cataract，ARC；ARC组）患者纳入本研究。两组患者均行超声乳化白内障吸出术联合IOL（Softec HD IOL）植入术。术后1周、1个月、3个月进行UL-OCT检查，并计算IOL偏心量、倾斜度及后囊膜与IOL后表面之间的面积（space between IOL and posterior capsule，IOL-PC space），采用两独立样本t检验比较各个随访时间点上的组间差异。结果　术后1周、1个月、3个月，PACG组IOL的偏心量分别为（0.182±0.054）mm、（0.232±0.081）mm、（0.183±0.089） mm，ARC组分别为（0.342±0.141）mm、（0.288±0.110）mm、（0.249±0.132）mm。术后1周PACG组IOL的偏心量小于ARC 组，差异具有统计学意义（P=0.006），两组其余时间点比较差异均无统计学意义（均为P>0.05）；术后1周、1个月、3个月，PACG组垂直轴上的倾斜度分别为（3.670±6.610）°、（-0.940±4.730）°、（0.540±9.510）°，ARC组分别为（-4.090±7.610）°、（-5.100±5.530）°、（-1.430±8.800）°。术后1周PACG组垂直轴上的倾斜度小于ARC组，差异具有统计学意义（P=0.025），其余时间点两组比较差异均无统计学意义（均为P>0.05）。IOL在水平轴上的倾斜度组间各时间点比较，差异均无统计学意义（均为P>0.05）。术后1周、1个月、3个月，PACG组水平轴上的IOL-PC space分别为（0.111±0.091）mm²、（0.044±0.066）mm²、（0.055±0.055）mm²，ARC组分别为（0.176±0.213）mm²、（0.255±0.303）mm²、（0.059±0.066）mm²，术后1个月PACG组IOL-PC space小于ARC 组，差异具有统计学意义（P=0.045），其余时间点两组比较差异均无统计学意义（均为P>0.05）。垂直轴上IOL-PC space各时间点两组间比较差异均无统计学意义（均为P>0.05）。结论　术后3个月内，Softec HD IOL在PACG组中的稳定性在一定程度上优于ARC组。

The stability of intraocular lenses in primary angle-closure glaucoma after phacoemulsification

Objective　To observe the stability of intraocular lens （IOL） in primary angle-closure glaucoma by ultra-long scan depth spectral domain optical coherence tomography （UL-OCT） after the phacoemulsification.Methods　Totally 42 patients （42 eyes） with primary closed-angle glaucoma （PACG） and age-，gender-matched 40 patients （40 eyes） with age-related cataract were included in the study.All of patients underwent phacoemulsification combined with softec HD IOL implantation.Images were obtained by UL- OCT in 1 week，1 month and 3 months after the surgery for the calculation and analysis of the IOL decentration，tilt and the space between IOL and posterior capsule （IOL-PC space）.And finally the intergroup differences at the different time-points were compared with the independent sample t test.Results　The IOL decentration after 1 week，1 month and 3 months was （0.182±0.054）mm，（0.232±0.081）mm，（0.183±0.089）mm in the PACG group，and （0.342±0.141）mm，（0.288±0.110）mm，（0.249±0.132）mm in the ARC group.There was statistically significant difference in IOL decentration 1 week after surgery between the two groups （P=0.006），but the differences in this variable at the other two time-points between the two groups were not statistically significant （both P>0.05）.The tilt on the vertical axis at 1 week，1 month and 3 months after surgery was （3.670±6.610）°，（-0.940±4.730）°，（0.540±9.510）° in the PACG group，and （-4.090±7.610）°，（-5.100±5.530）°，（-1.430±8.800）° in the ARC group.The tilt on the vertical axis of the PACG group was less than that of the ARC group at 1 week after surgery，with statistical difference （P=0.025），but there was no significant difference in this variable at the other two time-points （both P>0.05）.Moreover，the tilt on the horizontal axis showed no statistically significant differences （all P>0.05）.The IOL-PC space on horizontal axis at 1 week，1 month and 3 months after surgery was （0.111±0.091）mm²，（0.044±0.066）mm²，（0.055±0.055）mm² in the PACG group，and （0.176±0.213）mm²，（0.255±0.303）mm²，（0.059±0.066）mm² in the ARC group.The IOL-PC space on horizontal axis of the PACG group was less than that of the ARC group at 1 month after surgery，with statistical difference （P=0.045），but there was no significant difference in this variable at the other two time-points （both P>0.05）.Moreover，the IOL-PC space on vertical axis showed no statistically significant differences （all P>0.05）.Conclusion　The stability of Softec IOL in the PACG group is better than that in ARC group in 3 months after phacoemulsification.