摘要目的 分析不同年龄组原发性闭角型青光眼(PACG)患者眼结构参数及手术疗效.方法 前瞻性病例系列研究.选取2012年2月～2015年2月住院的62例(121眼)PACG为治疗组,另选＜40岁正常人30例(60眼)为对照组均测定眼结构参数并分析治疗组行小梁切除术的疗效.结果 PACG患者中＜40岁的25例(50眼),≥40岁者37例(71眼);PACG患者两年龄组前房深度、晶状体厚度和眼轴长度依次为(1.85 ±0.32) mm、(4.51 ±0.43) mm、(21.78±1.09) mm和(1.79±0.23) mm、(4.56 ±0.68)mm、(22.29 ±0.83)mm.两组年龄组间眼轴长度比较有统计学意义(P＜0.01);正常对照组的前房深度、晶状体厚度和眼轴长度依次为(2.96 ±0.37)mm、(3.90 ±0.56) mm和(23.77±1.14)mm,三组间各参数的总体差异均有统计学意义(P＜0.05).PACG两年龄组患者眼压手术前后比较有统计学意义(P＜0.01).术后出现睫状环阻塞性青光眼者中:＜40岁者占20％,≥40岁者占1.92％ (x2 =8.371,P=0.004).结论 PACG患者的眼轴较短、前房较浅及晶状体较厚,＜40岁者眼轴更短.小梁切除术可有效降低眼压,但＜40岁者术后易发生睫状环阻塞性青光眼.

abstractsObjective To analyze the ocular structural parameters and the surgical effect of patients with primary angle closure glaucoma (PACG) in different age group.Methods Prospective case series study.Total 121 eyes of 62 patients with PACG were collected from Feb.2012 to Feb.2015 as treatment group.There were 60 eyes of 30 normal people with ＜40 years old as control group(group A).The anterior chamber depth (ACD),lens thickness (LD) and axial length (AL) were measured and analyzed.The treatment group underwent trabeculectomy,the surgical effects were observed.Results There were 50 eyes of 25 patients with aged ＜40 as group B in the treatment group.The ACD,LT and AL of group B were (1.85 ± 0.32) mm,(4.51 ± 0.43) mm and (21.78 ± 1.09) mm,respectively.There were 71 eyes of 37 patients aged ≥40 as group C in the treatment group.The ACD,LT and AL were (1.79 ± 0.23) mm,(4.56 ±0.68) mm and (22.29 ±0.83) mm,respectively.The difference of AL was statistically significant between group B and group C (P＜0.01).The ACD,LTand ALofgroup A were (2.96±0.37) mm,(3.90 ± 0.56) mm and (23.77 ± 1.14) mm,respectively.The overall differences in ocular parameters were statistically significant among 3 groups (P ＜0.01).The difference in IOP of patients with PAEG was statistically significant between before and after surgery (P ＜ 0.01).During the follow-up period,malignant glaucoma occurred in 20％ patients in group B and 1.92％ patients in group C,and the difference was significant(x2 =8.371,P =0.004).Conclusion PACG patients are with shorter AL,shallow anterior chamber and thick lens.AL of PACG patients ＜ 40 years is more shorter.Trabeculectomy can effectively control the IOP,the malignant glaucoma is likely to occurr in PACG patients with ＜40 years old.