PACG激光虹膜切开术前后前节OCT扫描各参数变化研究

Comparison of anterior segment changes before and after laser peripheral iridotomy by anterior segment optical coherence tomography in eyes with primary angle-closure glaucoma

摘要:

目的：观察原发性闭角青光眼(primary angle closure glaucoma，PACG)行激光虹膜切开术前后前节OCT扫描参数变化。

方法：原发性闭角型青光眼30例42眼1/2以上象限房角开放，进行自身对照研究，利用前节OCT于激光虹膜切开术前及术后4wk进行检查，主要指标包括：前房角开放距离、小梁网与虹膜间面积、中央前房深度。术前术后检测参数比较，服从正态分布采用配对t检验，不服从正态分布的采用秩和检验。

结果：PACG患者30例42眼LPI术前距巩膜突500μm处，前房角开放距离0.172±0.078μm，小梁网与虹膜间面积0.066±0.025mm²； 距巩膜突750μm处，前房角开放距离0.268±0.133μm，小梁网与虹膜间面积0.122±0.045mm²； LPI术后距巩膜突500μm处，前房角开放距离0.277±0.105μm，小梁网与虹膜间面积0.113±0.041mm² ； 距巩膜突750μm处，前房角开放距离0.388±0.154μm，小梁网与虹膜间面积0.194±0.063mm²(P<0.05)差异有统计学意义，但前房深度无明显变化，差异无统计学意义(P=0.108)。

结论：激光虹膜切开术可以解决瞳孔阻滞，使前房角开放距离、小梁网与虹膜间面积增加，但前房深度不变。

Abstract:

AIM: To evaluate the changes of anterior segment configuration after laser peripheral iridotomy(LPI)in patients with primary angle-closure glaucoma(PACG)by using anterior segment optical coherence tomography(AS-OCT).

METHODS: This retrospective self control study consisted of forty-two eyes of 30 patients with PACG whose open angles were more than 180 degree. Central anterior chamber depth(ACD), opening distance(AOD), trabecular iris area(TISA)were measured using AS-OCT before and four weeks after LPI.

RESULTS: The parameters of AS-OCT on baseline were AOD 0.172±0.078μm, TISA 0.066±0.025mm² at 500μm anterior to sclera spur, and AOD 0.268±0.133μm, TISA 0.122±0.045mm² at 750μm. After LPI, the parameters were AOD 0.277±0.105μm, TISA 0.113±0.041mm² at 500μm, and AOD 0.388±0.154μm, TISA 0.194±0.063mm² at 750μm, which were significantly increased compared with the baseline(P<0.05). There was no significant difference on ACD before and after LPI(P=0.108).

CONCLUSION: PACG can be controlled by LPI resulting in an increase of AOD, TISA but not ACD.