目的:观察研究新疆哈萨克族慢性闭角型青光眼患者前房角组织的病理改变及临床意义。方法:对手术切除的小梁和虹膜组织常规脱水石蜡包埋,作矢状连续切片,苏木素-伊红染色,光镜下观察。结果:镜下见小梁网眼变窄或消失,内皮细胞减少,小梁网中有色素沉积,部分小梁网完全被色素斑块遮盖,看不清小梁结构,部分可见小梁虹膜并置,小梁纤维化伴玻璃样变性。Schlemm腔内壁内皮细胞不同程度增生,致管腔呈不规则狭窄甚至管腔闭塞,部分管腔内可见色素沉积。虹膜变薄,基质疏松,有的虹膜间质血管壁增厚并呈玻璃样变,部分可见虹膜间质薄壁血管形成。结论:慢性闭角型青光眼前房角组织的病理损伤是一个渐进的过程,早期诊断,早期治疗,既可以有效地防止视功能的损害,又能有效地预防因高眼压而造成的前房角组织的损害。

AIM:To study the pathological changes and clinical significance of anterior chamber angle of chronic angle-closure glaucoma patients in Kazak.METHODS:Trabecular meshwork and iris were removed by trabeculectomy,then embedded in paraffin for serial sections,hematoxylin staining and light microscope examination.RESULTS:The narrowing of trabecular meshwork and decreased endothelial cells with pigment deposition were observed by microscope examination in the trabecular meshwork.Some part of the trabecular meshwork was completely covered with pigment patch and trabecular structure could not be seen,the others were observed as trabecular meshwork fibrosis with hyaline degeneration.There was proliferation of endothelial cells in trabecular meshwork which caused lumen stenosis or occlusion.Some part of the lumen had pigment deposition with iris thinning and thickening of the iris vessel wall with hyaline.Iris stromal angiogenesis was visible in some part.CONCLUSION:The pathological damage in the anterior chamber angle is a gradual process in chronic angle-closure glaucoma patients.Early diagnosis and treatment can not only effectively prevent the damage of visual function,but also effectively prevent anterior chamber damage caused by high intraocular pressure(IOP).

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