【作者】 李星仪；

【导师】 姚玉峰；

【作者基本信息】 浙江大学 ， 眼科学， 2007， 硕士

【摘要】 目的：运用周边前房深度Van Herick分级法，前房角镜，眼部A超，超声生物显微镜(ultrasound biomiscroscopy UBM)评价行激光周边虹膜切除术(laser peripheral iridotomyLPI)术前术后眼前节结构变化。资料与方法：回顾性研究在2006年3月至2007年2月期间至浙江大学附属邵逸夫医院眼科诊断为可关闭房角并行双眼LPI的患者的临床资料。观察患眼术前术后UBM图像的变化，并比较术前术后眼前节结构参数包括周边前房深度Van Herick分级，眼部A超测量前房深度，UBM检查房角开放距离(angle-opening distance AOD)、前房角度，房角镜检查Scheie分级等的变化。结果：在2006年3月至2007年2月间在我院诊断为可关闭房角并接受双眼LPI的患者共34名(7男，27女)。完成随访的共15名患者(1男，14女)共30眼。其中10人双眼为可关闭房角，5人单眼为可关闭房角，可关闭房角25眼，占总眼数78.1％。LPI术后周边前房深度，房角镜检查术后4个象限房角(Scheie分级法)均显著变宽(P＜0.001)。UBM图像可见LPI术后前房结构变宽，UBM测量AOD及前房角度显著增大(P＜0.001)。眼压、眼轴长、晶体厚度、中央前房深度均无显著变化。25只可关闭房角眼术后9眼仍为可关闭房角，占总可关闭房角眼数36％。这9眼术后各象限房角Scheie分级无显著增加，周边前房深度(P＜0.001)，UBM见这9眼LPI术后前房结构有所加宽，UBM测量AOD，前房角度显著增大(P＜0.05)。结论：LPI术后前房角结构变宽，中央前房深度未见明显变化。UBM能直观地观察LPI术前术后眼前节结构的细微变化，并能定量评价LPI术后房角开放距离和前房角度的变化。部分可关闭房角患眼在LPI术后借助UBM可以观察到房角镜检查观察不到的细微变化。更多还原

【Abstract】 Purpose: To prospectively quantify changes in anterior segment morphology after laser peripheral iridotomy(LPI) using the Van Herick grade of peripheral anterior chamber depth, A-scan ultrasonography, gonioscopy and ultrasound biomiscroscopy(UBM) in eyes with occludable angles, which were diagnosed in physical examination without acute attack. To research effect of LPI to eyes with occludable angles.Methods: The eyes with occludable angles were diagnosed in the health examination in Sir Run Run Shaw hospital during March 2006 to February 2007. The eyes were examed by the Van Herick grade of limbal anterior chamber depth, A-scan ultrasonography, gonioscopy and ultrasound biomiscroscopy(UBM) before and after performed the LPI. The results of pre- and post LPI, including the anterior chamber depth, the angle open distance and the degree of the anterior chamber angle, were statistical analysed.Result: There were 34 patients who were diagnosed occludable-angle eyes and performed LPI during March 2006 to February 2007. Fifteen patients (thirty eyes)were examed. Ten patients of them were bilateral occludable-angle eyes, and five patients were unilateral occludable-angle eye. There were 25 occludable-angle eyes, 78.1% of all eyes.The peripheral anterior chamber depth and gonioscopy grading of the chamber angle significantly increased in all 4 quadrants(p<0.001). The morphology of the anterior chambers was wider showed by the UBM figures. AOD500 and the anterior chamber angle allsignificantly increased after LPI(p<0.001).The anterior chamber depth examed by A-scan ultrasonography did not change significantly.9 eyes of the occludable-angle eyes were still occludable-angle eyes, 36% of the 25 occludable-angle eyes. The gonioscopy grading of the chamber angle didn’t significantly increased in 4 quadrants. The peripheral anterior chamber depth(p<0.001), AOD500 and the anterior chamber angle (p<0.05)all significantly increased after LPI.Conclusions: In occludable-angle eyes, LPI produced a significant widening of the anterior chamber angle without deepening the central anterior chamber. UBM could be used to observe the fine morphplogy after the LPI directly, measure the parameters and watch some change which was not able to watch by the gonioscopy.更多还原