应用OCT评价激光周边虹膜成形联合切除术治疗临床前期原发性闭角型青光眼的有效性

Effectiveness evaluation of laser peripheral iridoplasty combined with iridectomy in preclinical primary angle-closure glaucoma by optical coherence tomography

摘要:

目的：应用光学相干断层扫描技术(OCT)评价激光周边虹膜成形联合切除术(LPI)治疗临床前期原发性闭角型青光眼(PACG)的有效性。

方法：选取PACG临床前期患者31例58眼进行激光周边虹膜成形联合切除术，应用OCT和眼科A超采集激光治疗前、治疗后1wk，2mo患眼的前房角形态、房角开放度(OA)以及眼前节生物参数：中央前房深度(ACD)、晶状体厚度(LT)、前房拥挤率(CCR)、晶状体位置(LP)。

结果：激光治疗前、治疗后1wk，2mo不同时间，眼压、OA、ACD、CCR、LP比较差异具有统计学意义(F=16.845、30.498、38.705、86.671、46.195，P<0.05)； LT差异无统计学意义(F=0.756，P=0.471)。激光治疗后1wk，2mo两两比较：仅CCR差异具有统计学意义(P<0.05)，OA、ACD、LP差异无统计学意义(P=0.067、0.359、0.406)。

结论：OCT可以观测和量化PACG前房角，CCR可以更加敏感的反应出前房的结构改变，LPI治疗早期PACG是有效的。

Abstract:

AIM:To evaluate the effectiveness of laser peripheral iridoplasty combined with iridectomy in preclinical primary angle-closure glaucoma(PACG)by optical coherence tomography(OCT).

METHODS:Fifty-eight eyes of 31 patients with preclinical PACG were received laser peripheral iridoplasty combined with iridectomy. Images of anterior chamber angle in three different time(before treatment,1wk after treatment and 2mo after treatment)were collected by OCT. Anterior chamber depth(ACD), lens thickness(LT), chamber crowding rate(CCR)and lens position(LP)were measured by A-ultrasound.

RESULTS:Intraocular pressure(IOP), OA, ACD, CCR, LP were statistically significant differences in three different time(IOP:F=16.845, OA:F=30.498, ACD:F=38.705, CCR:F=86.671, LP:F=46.195; P<0.05), but not LT(F=0.756, P=0.471). However, there were statistically significant differences only in CCR but not in OA, ACD and LP(P=0.067, 0.359, 0.406)between 1wk after treatment group and 2mo after treatment group(P<0.05).

CONCLUSION:OCT can be used to monitor and quantify anterior chamber of PACG. CCR can be more sensitive to reflect structural changes of anterior chamber. LPI is an effective treatment for early PACG.