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目的研究人工晶状体植入术后前房角宽度及眼压变化情况之间的相关性。方法随机选取120例(137只眼)老年性白内障患者,于表麻下行透明角膜切口超声乳化白内障摘除人工晶状体植入术,保留手术过程顺利、后囊膜完整、人工晶状体植入囊袋中的病例作为研究对象。术前用超声生物显微镜(UBM)测量房角相关参数:房角开放距离(AOD500)、小梁虹膜夹角(TIA)、前房深度(ACD);用Goldmann眼压计测量眼压。分别于术后2周、1个月、3个月再用UBM及Goldmann眼压计复查如上参数;术前以前房角镜观察并记录房角形态并于术后1个月复查房角形态。结果术前所测量的眼压与正常眼前节数据有显著性差异;术前所测量的ACD、AOD、TIA、眼压分别与术后2周、1个月、3个月复查数据进行多样本均数间的多重比较,均为P<0.05,均有显著性差异;术后2周、1个月、3个月时,AOD及眼压改变的量之间存在负相关;TIA夹角及眼压改变的量之间存在负相关。结论 (1)研究对象的ACD、AOD、TIA与正常眼前节相关数据比较,无显著性差异;但是,眼压较正常值稍高,提示部分患者有发生闭角型青光眼的潜在趋势。(2)超声乳化白内障摘除人工晶状体植入术后,前房深度及房角宽度显著增大,眼压显著降低,避免或减少了闭角型青光眼的发生机会。(3)AOD、TIA这2个变量与眼压这个变量间呈负相关。提示在老年人群中,AOD、TIA是影响眼压的重要因素。
Objective To study the correlation between anterior chamber angle width and intraocular pressure (IOP) changes after intraocular lens implantation. Methods A total of 120 patients (137 eyes) with senile cataract were randomly selected and underwent phacoemulsification and cataract extraction with intraocular lens implantation. The procedure was completed, the posterior capsule was intact and the intraocular lens was implanted into the capsular bag Case as a research object. Before operation, the angle-related parameters were measured by UBM: AOD500, TIA and ACD; Intraocular pressure was measured with Goldmann tonometer. Respectively at 2 weeks, 1 month, 3 months after surgery and then UBM and Goldmann tonometer to review the above parameters; preoperative gonocular angle observation and record the angle and 1 month after surgery to review the angle. Results The intraocular pressure measured before surgery was significantly different from the data of normal anterior segment. The preoperative ACD, AOD, TIA and intraocular pressure were compared with those of 2 weeks, 1 month and 3 months after operation respectively. There was a significant difference between the multiple comparison of mean, P <0.05, there was a negative correlation between AOD and IOP at 2 weeks, 1 month and 3 months after operation; There is a negative correlation between changes in intraocular pressure. Conclusions (1) There is no significant difference between the data of ACD, AOD and TIA and the data of normal anterior segment. However, the intraocular pressure is slightly higher than the normal value, suggesting that some patients have the potential tendency of angle-closure glaucoma. (2) After phacoemulsification cataract extraction and intraocular lens implantation, the depth of the anterior chamber and the width of the anterior chamber angle were significantly increased, the intraocular pressure was significantly reduced, and the occurrence of angle-closure glaucoma was avoided or reduced. (3) AOD, TIA these two variables and intraocular pressure was negatively correlated between this variable. Tip in the elderly population, AOD, TIA is an important factor affecting intraocular pressure.