Anterior Chamber Angle Assessment by Anterior-segment Optical Coherence Tomography After Phacoemulsification With or Without Goniosynechialysis in Patients With Primary Angle Closure Glaucoma
Anterior Chamber Angle Assessment by Anterior-segment Optical Coherence Tomography After Phacoemulsification With or Without Goniosynechialysis in Patients With Primary Angle Closure Glaucoma
复制标题
原发性闭角型青光眼患者超声乳化术后伴或不伴房角粘连分离后通过前段光学相干断层扫描评估前房角
DOI：
10.1097/ijg.0000000000000061
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发表时间：
2015-12-01
影响因子：
2
通讯作者：
Qian, Shaohong
中科院分区：
文献类型：
--
作者：
Shao, Tingting;Hong, Jiaxu;Qian, Shaohong
目的：应用前节光学相干断层扫描（AS-OCT）评价原发性闭角型青光眼（PACG）患者超声乳化白内障吸除术（phaco）联合房角粘连分离术（GSL）前后前房角（ACA）的变化。方法：将PACG患者纳入2项比较超声乳化GSL与超声乳化的随机对照试验进行汇总分析。在术前、术后1周、2周、1个月、3个月和6个月通过AS-OCT获得ACA图像。分析以下参数：距巩膜突500和750 m处的开角距离（AOD）、500和750 m处的小梁-虹膜间隙面积（TISA）、500和750 m处的房角凹陷面积（ARA）和巩膜突角（SSA）。结果：超声乳化组ACA各项参数均较术前明显升高（P<0.001），而超声乳化组ACA各项参数无明显升高。术后1、3、6个月的AOD 500（P<0.05）、ARA 750（P<0.05）、TISA 500（P<0.05）、TISA 750（P <0.05）及术后3、6个月的SSA（P<0.05）与眼压呈负相关。在超声乳化-GSL组中，23/23只眼术后IOP<21 mm Hg，未使用任何抗青光眼药物。超声乳化组20只眼中12只眼（60%）眼压<21 mm Hg，未用药，8只眼（15%）术后眼压<21 mm Hg且无法控制（25%）需用药。结论：在我们的研究中，在超声乳化GSL后，在AS-OCT评估中，PACG眼的ACA打开并显著增宽。提示AOD 500、ARA 750、TISA 500、TISA 750和SSA可为评估超声乳化GSL的有效性提供有价值的信息。
Purpose:To evaluate changes of anterior chamber angle (ACA) by anterior-segment optical coherence tomography (AS-OCT) in patients with primary angle closure glaucoma (PACG) following phacoemulsification (phaco) with or without goniosynechialysis (GSL). Methods:Patients with PACG recruited into 2 randomized controlled trials comparing phaco-GSL versus phaco were pooled for analysis. Images of ACA were obtained by AS-OCT before surgery, and at 1 and 2 weeks, and 1, 3, and 6 months after surgery. The following parameters were analyzed: angle opening distance (AOD) at 500 and 750 &mgr;m from the scleral spur, trabecular-iris space area (TISA) at 500 and 750 &mgr;m, angle recess area (ARA) at 500 and 750 &mgr;m, and scleral spur angle (SSA). Results:All parameters of ACA increased significantly after phaco-GSL (P<0.001), whereas no increase occurred in the phaco group. Negatively significant correlations were found in &Dgr;AOD500 (P<0.05), &Dgr;ARA750 (P<0.05), &Dgr;TISA500 (P<0.05), and &Dgr;TISA750 (P<0.05) at 1, 3, and 6 months, and &Dgr;SSA (P<0.05) at 3 and 6 months after phaco-GSL against &Dgr; intraocular pressure (IOP). In the phaco-GSL group, 23 of 23 eyes had IOP<21 mm Hg without any antiglaucoma medication postoperatively. In the phaco group, 12 of 20 eyes (60%) had IOP<21 mm Hg without medication, 8 of 20 eyes required medication with IOP<21 mm Hg (15%) and uncontrollable IOP (25%) after surgery. Conclusions:On AS-OCT evaluation, ACA in eyes with PACG opened and widened significantly after phaco-GSL in our study. It is suggested that &Dgr;AOD500, &Dgr;ARA750, &Dgr;TISA500, &Dgr;TISA750, and &Dgr;SSA would provide valuable information to estimate the effectiveness of phaco-GSL.