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ENGLISH ABSTRACT
Pentacam对原发性闭角型青光眼激光周边虹膜切开术前后前房形态和参数的评估
刘晓丽
刘丹岩
张斌
郭从容
杜颖华
段佳良
作者及单位信息
·
DOI： 10.3760/cma.j.issn.2095-0160.2016.07.008
The morphologic and quantitative evaluation of ocular anterior chamber parameters after laser peripheral iridotomy in primary angle-closure glaucoma eyes
Liu Xiaoli
Liu Danyan
Zhang Bin
Guo Congrong
Du Yinghua
Duan Jialiang
Authors Info & Affiliations
Liu Xiaoli
Department of Ophthalmology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
Liu Danyan
Zhang Bin
Guo Congrong
Du Yinghua
Duan Jialiang
·
DOI： 10.3760/cma.j.issn.2095-0160.2016.07.008
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摘要

背景Pentacam三维眼前节分析诊断系统(Pentacam)在对原发性闭角型青光眼(PACG)眼前节的定量评估中比裂隙灯显微镜和超声生物显微镜(UBM)更为准确，但目前其在急性PACG临床前期眼和慢性PACG对侧眼的YAG激光虹膜周边切开术(LPI)后前房测量中的应用仍较少。

目的评估Pentacam在早期PACG眼LPI手术前后前房形态变化及其应用价值。

方法采用前瞻性自身对照研究设计，纳入2012年7月至2013年12月在河北医科大学第二医院确诊的PACG患者70例70眼，包括急性PACG对侧眼(临床前期眼)和慢性PACG对侧眼各35眼，所有受检眼均行LPI。采用Pentacam测量受检眼LPI术前与术后1、7和28 d的前房深度(ACD)、前房容积(ACV)和前房夹角(ACA)，并比较急性PACG临床前期眼与慢性PACG对侧眼LPI术后前房形态参数的变化幅度。

结果急性PACG临床前期眼各时间点ACD和ACV的总体比较差异均有统计学意义(ACD： F＝6.783， P＝0.004；ACV： F＝19.090， P＝0.000)，各时间点ACA值变化差异无统计学意义( F＝0.153， P＝0.928)，其中LPI术后各时间点ACD较术前加深，ACV较术前增加，差异均有统计学意义(均 P<0.05)。慢性PACG对侧眼各时间点ACD和ACV的总体比较差异有统计学意义(ACD： F＝21.576， P＝0.000；ACV： F＝47.506， P＝0.000)，而各时间点间ACA比较差异无统计学意义( F＝0.581， P＝0.629)，其中LPI术后各时间点ACD较术前加深，ACV较术前增加，差异均有统计学意义(均 P<0.05)。急性PACG临床前期眼术后28 d，ACD和ACV与术前的变化值分别为(0.064±0.022)mm和(27.840±4.963)mm 3，明显高于慢性PACG对侧眼的(0.047±0.020)mm和(21.000±3.278)mm 3，组间差异均有统计学意义(ACD： t＝2.783， P＝0.008；ACV： t＝5.749， P＝0.000)。

结论Pentacam可以用来量化评价PACG患者LPI后的眼前节形态和参数的变化，急性PACG临床前期眼术后ACD和ACV的增加值大于慢性PACG对侧眼。

闭角型青光眼/手术;前房/病理状态;生物测量;三维成像;眼科诊断技术/仪器;激光疗法;虹膜切开术;Pentacam三维眼前节分析诊断系统
ABSTRACT

BackgroundPentacam anterior segment analysis system(Pentacam) is more accurate in the quantitative evaluation of ocular anterior segment in primary angle-closure glaucoma (PACG) eyes than slit lamp microscope and ultrasound biomicroscope (UBM). However, its accuracy in the earlier stage of PACG before and after YAG laser peripheral iridotomy (LPI) is not fully elucidated.

ObjectiveThis study was to assess the effect of YAG LPI in PACG patients with Pentacam.

MethodsA prospective self-controlled study was performed.Thirty-five fellow eyes (pre-clinical stage of PACG) of acute PACG and 35 fellow eyes of chronic PACG were included in the Second Hospital of Hebei Medical University from July, 2012 to December, 2013.YAG LPI was performed on the eyes, and the parameters of ocular anterior segment including central anterior chamber depth (ACD), anterior chamber volume (ACV) and peripheral anterior chamber angle (ACA) were measured and compared by Pentacam before and 1 day, 7 days, 28 days after operation.This study was approved by the Ethic Committee of the Second Hospital of Hebei Medical University and informed consent was obtained from all subjects.

ResultsIn pre-clinical stage of PACG eyes, the postoperative ACD and ACV values were increased in comparison with preoperation, showing significant differences among various time points (ACD: F=6.783, P=0.004; ACV: F=19.090, P=0.000), and no significant difference was found in ACA among different time points ( F=0.153, P=0.928). In the fellow eyes of chronic PACG, the postoperative ACD and ACV values were larger than those of preoperation, with significant differences among various time points (ACD: F=21.576, P=0.000; ACV: F=47.506, P=0.000), and no significant difference was found in ACA among different time points ( F=0.581, P=0.629). The change values of ACD and ACV were (0.064±0.022)mm and (27.840±4.963)mm 3 in the eyes of pre-clinical stage of PACG, and those in the fellow eyes of chronic PACG were (0.047±0.020)mm and (21.000±3.278)mm 3, showing significant differences between the two groups (ACD: t=2.783, P=0.008; ACV: t=5.749, P=0.000).

ConclusionsPentacam allows easy, fast, automatic and non-contact quantification and three-dimension image of the anterior chamber parameters before and after YAG LPI in pre-clinical stage of PACG eyes and fellow eyes of chronic PACG.The ACD deepens and ACV increases after LPI in glaucomous eyes, especially in the pre-clinical stage of PACG eyes.

Glaucoma, angle-closure/surgery;Anterior chamber/pathology;Biometry;Imaging, three-dimensional;Diagnostic techniques, ophthalmological/instrumentation;Laser therapy;Iridectomy;Pentacam anterior segment analysis system
Liu Danyan, Email: mocdef.aabnisnaynaduil
Fund program: Trial Techndogy Tracking Projeet of Health Department in Hebei Province(G2015024)
Copyright by Chinese Medical Association
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引用本文

刘晓丽,刘丹岩,张斌,等. Pentacam对原发性闭角型青光眼激光周边虹膜切开术前后前房形态和参数的评估[J]. 中华实验眼科杂志,2016,34(7)：608-612.

DOI:10.3760/cma.j.issn.2095-0160.2016.07.008

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作为新型三维眼前节分析系统，Pentacam可在2 s内一次性获得完整的眼前节图像，并可提供较为全面的眼前节生物学参数，如前房深度(anterior chamber depth，ACD)、前房容积(anterior chamber volume，ACV)和前房夹角(anterior chamber angle，ACA) [ 1 ]，它具有图像分辨率高、定位准确、测量结果精确、可数字化储存等优点，有利于进行治疗前后的随访对比。YAG激光周边虹膜切开术(laser peripheral iridotomy，LPI)已经成为原发性闭角型青光眼(primary angle-closure glaucoma，PACG)治疗的重要手段之一 [ 2 ]。本研究中应用Pentacam三维眼前节分析诊断系统(Pentacam)测量急性PACG对侧眼(临床前期眼)、慢性PACG对侧眼YAG LPI术前及术后眼前节参数的变化，量化评价YAG LPI治疗早期PACG的效果。
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备注信息
A
刘丹岩，Email： mocdef.aabnisnaynaduil
B
河北省卫生厅试用技术跟踪项目 (G2015024)
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