应用前节OCT检测超声乳化联合房角分离术后睫状体脉络膜上腔积液
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Supraciliochoroidal fluid detected by anterior segment OCT after phacoemulcification combined with goniosynechialysis
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    摘要:

    目的:通过前节OCT检测超声乳化联合房角分离术后1wk内睫状体脉络膜上腔积液(supraciliochoroidal fluid,SCF)的发生情况。

    方法:选取2016-01/2017-06于我院行超声乳化吸除联合房角分离术的PACG合并白内障患者40例40眼,通过前节OCT评估术后SCF发生情况,将术后1wk内发生SCF的患者纳入发生SCF组(10例10眼),未发生SCF的患者纳入未发生SCF组(30例30眼)。分析两组患者眼压、中央前房深度、黄斑中心凹厚度(central macular thickness,CMT)、最佳矫正视力(best corrected visual acuity,BCVA)情况。

    结果:所有患眼术前均未发现SCF,术后1wk内10眼(25%)发生SCF,分别发生于术后1d(2眼)、术后3d(7眼)、术后1wk(1眼)。SCF累及范围分别为4个象限7眼、2个象限2眼、1个象限1眼。SCF的严重程度分别为Ⅰ级8眼、Ⅱ级2眼。术后4wk,9眼SCF消失; 术后8wk,全部消失。发生SCF组患者术后1wk内最低眼压(8.9±0.9mmHg)低于未发生SCF组(12.5±2.6mmHg),差异有统计学意义(P<0.001)。SCF发生时患者的平均眼压为10.0±1.2mmHg,SCF消失时的眼压增加至14.3±1.5mmHg,差异有统计学意义(P<0.001)。Spearman相关分析显示,术后8wk,BCVA与CMT呈正相关(rs=0.838,P<0.001)。

    结论:超声乳化联合房角分离术后超早期(术后1wk内)可采用前节OCT检查SCF的发生情况,具有较高的临床价值。

    Abstract:

    AIM: To evaluate the incidence of supraciliochoroidal fluid(SCF)within 1wk after phacoemulsification combined with goniosynechialysis by anterior segment optical coherence tomography(AS-OCT).

    METHODS: AS-OCT was used to analyze the incidence of SCF in 40 eyes of 40 patients who received phacoemulsification combined with goniosynechialysis from January 2016 to June 2017. All the patients were diagnosed with primary acute angle-closure glaucoma(PACG)along with cataract. Patients with SCF occurring in 1wk after surgery were included in the SCF group(10 cases with 10 eyes), and patients without SCF were included in the non-occurrence SCF group(30 cases with 30 eyes). Data of intraocular pressure(IOP), central depth of anterior chamber, central macular thickness(CMT), and best corrected visual acuity(BCVA)were collected to further analysis.

    RESULTS: All the 40 eyes displayed no SCF before surgery. SCF was detected in 10 eyes(25%), which first occurred on 1d(2 eyes), 3d(7 eyes), and 1wk(1 eye)within 1wk postoperatively. SCF was detected in four(7 eyes), two(2 eyes), and one quadrant(1 eye). The whole 10 eyes showed grade Ⅰ(8 eyes)or grade Ⅱ detachment(2 eyes), with no eyes showing grade Ⅲ detachment. Nine eyes had showed no SCF by 4wk, and all SCF disappeared on 8wk. The lowest IOP was significantly lower in eyes with SCF(8.9±0.9mmHg)than in those without(12.5±2.6mmHg)(P<0.001). The IOP rose from 10.0±1.2mmHg at the detection of SCF to 14.3±1.5mmHg at the disappearance of SCF(P<0.001). BCVA(LogMAR)showed significant positive correlation with central macula thickness(CMT)on postoperatively 8wk(rs=0.838, P<0.001).

    CONCLUSION: SCF can be detected frequently with AS-OCT at the very early stages after phacoemulsification combined with goniosynechialysis(within 1wk postoperatively), which has fine clinical value.

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何峰英.应用前节OCT检测超声乳化联合房角分离术后睫状体脉络膜上腔积液.国际眼科杂志, 2018,18(9):1687-1691.

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  • 收稿日期:2018-04-27
  • 最后修改日期:2018-08-08
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  • 在线发布日期: 2018-08-17
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