巩膜外加压术后早期高眼压的UBM临床观察
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Observation of the intraocular pressure elevation after sclera buckling surgery with ultrasound biomicroscopy
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    摘要:

    目的:通过超声生物显微镜(ultrasound biomiroscopy,UBM)观察巩膜外加压术后患者眼前节结构的改变,研究巩膜外加压术后眼前节结构改变与眼压升高之间的关系,探讨巩膜外加压术后眼压升高的机制。

    方法:将2011-07/2012-02于我科行巩膜外加压术(除去有原发性青光眼病史、青光眼家族史及房角存在新生血管的病例)的患者156例161眼纳入分析。所有患者在术前及术后均进行Topcon非接触眼压计眼压检查、裂隙灯眼前节检查、超声生物显微镜及房角镜、间接检眼镜等检查。比较高眼压组与正常眼压组术前术后各测量参数的改变,评价其与术后眼压变化之间的关系,从而研究巩膜外加压术后高眼压发生机制。

    结果:高眼压组术后可出现瞳孔阻滞,睫状体全周脱离、水肿、前旋。参数测量:高眼压组与正常眼压组前房深度相比差异有统计学意义(t=2.003,P=0.048),房角开放距离500(AOD500)高眼压组与正常眼压组相比差异有统计学意义(t=2.071,P=0.049),睫状体厚度比较差异有统计学意义(t=1.932,P=0.038)。

    结论:UBM在检查巩膜外加压术后眼前节结构方面行之有效。术后眼压升高是巩膜外加压术后的一个常见的并发症。术后早期(2wk内)ACD,AOD500及CBT等眼前节结构参数的改变与眼压的变化有密切的关系。术后睫状体水肿前旋致前房变浅、房角变窄,导致眼压升高,相关参数提示高眼压组术后较术前有前房变浅、房角开放程度减小的趋势。

    Abstract:

    AIM: To investigate the mechanism of intraocular pressure(IOP)elevation after scleral buckling surgery with ultrasound biomicroscopy(UBM).

    METHODS: A totally of 156 patients 161 eyes who underwent scleral buckling surgery operated by professor An-Huai Yang during July, 2011 and February, 2012 were selected in this retrospective study. All the patients were grouped by high IOP and normal IOP(not suffering from glaucoma and without glaucoma family history). The structure ofocular anterior segment was observed with UBM in all patients following scleral buckling surgery. We analyzed the relationship between IOP and the structure parameter of ocular anterior segment to investigate the mechanism of high IOP after scleral buckling surgery.

    RESULTS: By UBM, the main causes of high IOP after scleral buckling surgery wereadhesion of iris to trabecular meshwork and closure of anterior chamber angle. The high IOP group and normal IOP group had statistical differences in anterior chamber depth(ACD)(t=2.003, P=0.048), angle opening distance500(AOD500),(t=2.071, P=0.049)and ciliary body thickness(CBT)(t=1.932, P=0.038).

    CONCLUSION: UBM is effective in observation of the structure of ocular anterior segment after scleral buckling surgery and intraocular hypertension is a common complication. ACD, AOD500 and CBT changes are related to IOP changes soon after operation(in 2 weeks). The edema and forward rotation of ciliary body, the narrow of anterior chamber angle are the mainly factors resulting in high IOP after scleral buckling surgery. The high IOP group has a tendency to appear to be a shallow anterior chamber and narrow anterior chamber angle.

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曾云,杨安怀.巩膜外加压术后早期高眼压的UBM临床观察.国际眼科杂志, 2012,12(11):2138-2141.

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  • 收稿日期:2012-08-09
  • 最后修改日期:2012-10-09
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