Pentacam眼前节分析仪评价闭角型青光眼激光治疗前后眼前节参数变化研究
摘要
目的:探讨Pentacam眼前节分析仪对原发性闭角型青光眼诊断为窄房角(PACS)的患者行激光治疗前后眼前节各参数的变化。方法:收集诊断为PACS的患者(34例64眼),分别以行LPIP(14例27眼)及LPI(20例37眼)治疗,应用Pentacam眼前节分析仪对术前、术后中央前房深度(CACD)、周边前房深度(PACD)、前房容积(ACV)、前房角(ACA)等参数进行测量及比较,同时分别记录术前和术后的眼内压(IOP)、最佳矫正视力(BCVA)等数据。结果:LPIP术前与术后ACV比较(t=-2.409,P=0.023), CACD比较(t=1.121,P=0.273),ACA比较(t=-2.419,P=0.023),IOP比较(t=-2.587,P=0.032),BCVA比较(t=2.212,P=0.325),即行LPIP患者术后ACV、ACA、IOP与术前较差异均有统计学意义(P<0.05),术前的CACD、BCVA与术后比较差异均无统计学意义(P>0.05)。LPI术前与术后ACV比较(t=-6.507,P=0.000)mm,术前与术后CACD比较(t=-2.346,P=0.025),术前与术后ACA比较(t=-2.010,P=0.052),术前与术后IOP比较(t=-2.432,P=0.024),术前与术后BCVA比较(t=1.352,P=0.293),即行LPI患者术前的ACV、CACD、IOP与术后比较,差异均有统计学意义(P<0.05),术前的ACA、BCVA与术后比较,差异均无统计学意义(P>0.05)。而行LPIP和LPI患者CACD、ACV、ACA的术后比较差异均无统计学意义(P>0.05)。结论:①LPIP和LPI均可有效的治疗PACS患者。②Pentacam眼前节分析仪可用作PACS患者激光治疗术后随访观察眼前节变化的有效检查手段。③由于原发性闭角型青光眼的发病因素不同,故LPIP和LPI不可相互替代。
引文
[1] 王卫红,田祥.可拆式缝线小梁切除预防青光眼术后浅前房发生的疗效分析[J].陕西医学杂志,2007,36(6):715-716.
[2] 蒋艳华,吴照宇.激光虹膜切开术联合周边虹膜成形术在原发性闭角型疑似病例中的应用[J].中国激光医学杂志,2015,24(3):127.
[3] 葛坚,王宁利.眼科学[M].3版.北京:人民卫生出版社,2015:261.
[4] Foster PJ,Buhrmann R,Quigley HA,et al.The definition and classification of glaucoma in prevalence surveys[J].Br J Ophthelmol,2002,86(2):238-242.
[5] Thomas R,George R,Parikh R,et al.Five year risk of progressionof primary angle closure suspects to primary angle closure:a populationbased study[J].Br J Ophthalmol,2003,87:450-454.
[6] Thomas R,Parikh R,Muliyil J,et al.Five-year risk of progression of primary angle closure to primary angle closure glaucoma:a population-based study[J].Acta Ophthalmol Scand,2003,81:480-485.
[7] Ang MH,Baskaran M,Kumar RS,et al.National survey of ophthalmologists in Singapore for the assessment and management of asymptomatic angle closure[J].J Glaucoma,2008,17:1-4.
[8] Pandav SS,Kaushik S,Jain R,et al.Laser peripheral iridotomyacross the spectrum of primary angle closure[J].Can J Ophthalmol,2007,42:233-237.
[9] Robin AL,Pollack IP.Argon laser peripheral iridotomies in thetreatment of primary angle closure glaucoma:long-term follow-up[J].Arch Ophthalmol,1982,100:919-923.
[10] McGalliard JN,Wishart PK.The effect of Nd:YAG iridotomy on intraocular pressure in hypertensive eyes with shallow anterior chambers[J].Eye,1990,4:823-829.
[11] 王宁利,欧阳洁,周炳文,等.中国人闭角型青光眼房角关闭机制的研究[J].中华眼科杂志,2000,36:47-50.
[12] Kashiwagi K,Abe K,Tsukahara S.Quantitative evaluation of changes in anterior segment biometry by peripheral laser iridotomy using newly developed scanning peripheral nterior chamber depth analyzer[J].Br J Ophthalmol,2004,88:1036-1041.
[13] 邹燕红.青光眼发病机制与抗青光眼药物的进展[J].国际眼科纵览,1998,22(2):65-74.
[14] 程蕾,朱冉,魏梅,等.Pentacam 和UBM 在ICL 手术患者术前中央前房深度测量的比较[J].眼科新进展,2015,35(8):762-764.
[15] 章玉群,田琳璐,章翼,等.Pentacam眼前节分析系统在预防性激光虹膜周边切评估中的应用[J].国际眼科杂志,2013,13(1):64-68.
[16] 梁勇,任泽钦.Pentacam 前房分析仪测量原发性闭角型青光眼YAG 激光周边虹膜切除术前后前房形态参数的对比研究[J].中华眼视光学与视觉科学杂志,2011,13(1):51-54.
[17] 杜驰,李姝燕,张敏.应用Pentacam 评价激光周边虹膜切除术前后前房形态参数的改变[J].国际眼科杂志,2015,15(5):908-910.
[18] 邹吉新,张繁友,张立军,等.激光周边虹膜成形术治疗原发性闭角型青光眼房角相关机构的超声生物显微镜观察[J].中国实用眼科杂志,2006,24(8):798.
[2] 蒋艳华,吴照宇.激光虹膜切开术联合周边虹膜成形术在原发性闭角型疑似病例中的应用[J].中国激光医学杂志,2015,24(3):127.
[3] 葛坚,王宁利.眼科学[M].3版.北京:人民卫生出版社,2015:261.
[4] Foster PJ,Buhrmann R,Quigley HA,et al.The definition and classification of glaucoma in prevalence surveys[J].Br J Ophthelmol,2002,86(2):238-242.
[5] Thomas R,George R,Parikh R,et al.Five year risk of progressionof primary angle closure suspects to primary angle closure:a populationbased study[J].Br J Ophthalmol,2003,87:450-454.
[6] Thomas R,Parikh R,Muliyil J,et al.Five-year risk of progression of primary angle closure to primary angle closure glaucoma:a population-based study[J].Acta Ophthalmol Scand,2003,81:480-485.
[7] Ang MH,Baskaran M,Kumar RS,et al.National survey of ophthalmologists in Singapore for the assessment and management of asymptomatic angle closure[J].J Glaucoma,2008,17:1-4.
[8] Pandav SS,Kaushik S,Jain R,et al.Laser peripheral iridotomyacross the spectrum of primary angle closure[J].Can J Ophthalmol,2007,42:233-237.
[9] Robin AL,Pollack IP.Argon laser peripheral iridotomies in thetreatment of primary angle closure glaucoma:long-term follow-up[J].Arch Ophthalmol,1982,100:919-923.
[10] McGalliard JN,Wishart PK.The effect of Nd:YAG iridotomy on intraocular pressure in hypertensive eyes with shallow anterior chambers[J].Eye,1990,4:823-829.
[11] 王宁利,欧阳洁,周炳文,等.中国人闭角型青光眼房角关闭机制的研究[J].中华眼科杂志,2000,36:47-50.
[12] Kashiwagi K,Abe K,Tsukahara S.Quantitative evaluation of changes in anterior segment biometry by peripheral laser iridotomy using newly developed scanning peripheral nterior chamber depth analyzer[J].Br J Ophthalmol,2004,88:1036-1041.
[13] 邹燕红.青光眼发病机制与抗青光眼药物的进展[J].国际眼科纵览,1998,22(2):65-74.
[14] 程蕾,朱冉,魏梅,等.Pentacam 和UBM 在ICL 手术患者术前中央前房深度测量的比较[J].眼科新进展,2015,35(8):762-764.
[15] 章玉群,田琳璐,章翼,等.Pentacam眼前节分析系统在预防性激光虹膜周边切评估中的应用[J].国际眼科杂志,2013,13(1):64-68.
[16] 梁勇,任泽钦.Pentacam 前房分析仪测量原发性闭角型青光眼YAG 激光周边虹膜切除术前后前房形态参数的对比研究[J].中华眼视光学与视觉科学杂志,2011,13(1):51-54.
[17] 杜驰,李姝燕,张敏.应用Pentacam 评价激光周边虹膜切除术前后前房形态参数的改变[J].国际眼科杂志,2015,15(5):908-910.
[18] 邹吉新,张繁友,张立军,等.激光周边虹膜成形术治疗原发性闭角型青光眼房角相关机构的超声生物显微镜观察[J].中国实用眼科杂志,2006,24(8):798.