摘要目的 使用Pentacam三维前房分析仪和眼前段光学相干断层扫描仪(AS-OCT)观察超声乳化白内障吸出术对急性原发性闭角型青光眼(APACG)患者眼前段的影响.方法 收集2010年7月至12月于中山大学附属中山医院眼科就诊的伴有白内障APACG的病例共39例(39眼).常规行超声乳化白内障吸出联合人工晶体(IOL)植入术.术前和术后3个月使用Pentacam和AS-OCT测量眼前段参数.结果 术后3个月,APACG患者眼压由术前(33.08±5.21)mm Hg降至(16.36±3.44)mm Hg(1mm Hg=0.133 kPa,t=20.644,P=0.000),中央前房深度由(1.79±0.20)mm增至(3.41±0.38) mm (t=36.191,P=0.000),周边前房深度由(0.82±0.12) mm加深至(1.81 ±0.20) mm (t=40.732,P=0.000),前房容积自(74.10±9.94) mm增加至(149.72± 17.12) mm (t=54.921,P=0.000),下方前房角自(24.03±3.50).加宽至( 43.29±3.92).(t=55.489,P=0.000),鼻侧前房角自(23.02±2.96)°加宽至(42.36±4.61).(t=43.291,P=0.000),上方前房角自(21.62±3.04).加宽至(39.66±3.53).( t=43.511,P=0.000),颞侧前房角自(22.88±2.87).加宽至(41.21±3.81).(t=44.930,P=0.000).瞳孔直径由术前(3.06±1.32)mm缩小至术后的(3.00±1.21)mm,但差异无统计学意义(t=1.177,P=0.247).结论 超声乳化白内障吸出术可改善APACG患者眼前段结构的狭窄.Pentacam和AS-OCT可简便快捷和非接触地观察眼前段,有良好的应用前景.

abstractsObjective To investigate the morphological changes of anterior segment in patients with acute primary angle closure glaucoma (APACG) after phacoemulsification using the Pentacam three-dimension anterior chamber analysis system and anterior segment optical coherence tomography (AS-OCT).Methods Thirty- nine APACG patients (39 eyes) accompanied with cataract were treated with phacoemulsification from July 2010 to December 2010 in Zhongshan Hospital.All the patients were examined by Pentacam and AS-OCT preoperation and 3 months postoperation.Outcomes included intraocular pressure (IOP),central anterior chamber depth (CACD),peripheral anterior chamber depth (PACD),anterior chamber volume (ACV),pupil diameter (PD),and anterior chamber angle (ACA) on cross- section photographs.Results Mean IOP decreased from preoperative (33.08 ± 5.21) mm Hg to postoperative (16.36±3.44) mm Hg (1 mm Hg=0.133 kPa,t=20.644,P=0.000) and CACD measurements increased from (1.79±0.20) mm to (3.41±0.38) mm (t=36.191,P=0.000).PACD deepened from (0.82±0.12) mm to (1.81±0.20) mm (t=40.732,P=0.000).ACV increased from (74.10±9.94) mm to (149.72±17.12) mm (t=54.921,P=0.000).Inferior ACA widened from (24.03±3.50)° to (43.29±3.92)° (t=55.489,P=0.000),and from (23.02±2.96)° to (42.36±4.61)° (t=43.291,P=0.000) in nasal direction.Superior ACA widened from (21.62±3.04)° to (39.66±3.53)° (t=43.511,P=0.000),and from (22.88±2.87)° to (41.21±3.81)° (t=44.930,P=0.000) in temporal direction.PD before and after phacoemulsification were (3.06± 1.32) mm and (3.00 ± 1.21) mm (t=1.177,P=0.247) respectively,with no statistic difference.Conclusions Phacoemulsification can widen the angle and lessen angle crowding in APACG patients.The Pentacam and AS-OCT allow easy,fast,automatic and noncontact quantification of the anterior chamber parameters with good prospects.