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目的探讨闭角型青光眼患者滤过术后浅前房、术前睫状体脱离与眼压的关系。方法回顾分析2007年6月至2008年12月在我院住院的457例(472眼)原发性青光眼患者,入院时行UBM及眼压检查,将术前发生睫状体脱离且需行滤过手术的闭角型青光眼患者共22例(26眼)列为A组,随机选取30例(32眼)非睫状体脱离且行滤过手术的闭角型青光眼患者为B组,将A、B2组合并,根据术后是否发生浅前房分为浅前房组(C组)和非浅前房组(D组)。分析闭角型青光眼患者滤过术后浅前房、术前睫状体脱离与眼压的关系。结果 A、B2组患者所有检测指标差异均无统计学意义(均为P>0.05)。术后浅前房者14例(17眼),C、D组患者术前眼压分别为(49.90±4.70)mmHg(1kPa=7.5mmHg)、(3.71±3.02)mmHg;术后第1天眼压:C组(9.75±0.98)mmHg;D组(15.76±1.74)mmHg;眼压下降幅度:C组(38.30±4.33)mmHg、D组(19.04±2.72)mmHg;差异均有显著统计学意义(均为P<0.01)。术后C组与D组的角膜厚度、前房深度、小梁虹膜夹角为0°的象限个数及小梁睫状体距离比较,差异均无统计学意义(均为P>0.05),而虹膜晶状体夹角(C组:14.53°±0.44°;D组:12.74°±0.70°)差异有统计学意义(P<0.05)。结论小梁切除术前是否并发睫状体脱离与术后是否发生浅前房未见统计学相关性。术前眼压越高,虹膜晶状体夹角越大,治疗后眼压下降幅度越大,及术后第1天眼压越低,发生浅前房的可能性越大。
Objective To investigate the relationship between shallow anterior chamber anterior chamber closure, preoperative ciliary body detachment and intraocular pressure in patients with angle-closure glaucoma. Methods A total of 457 patients (472 eyes) with primary glaucoma hospitalized in our hospital from June 2007 to December 2008 were retrospectively analyzed. UBM and intraocular pressure (IOP) were examined at admission. A total of 22 patients (26 eyes) with closed-angle glaucoma undergoing surgery were enrolled in group A. Thirty patients (32 eyes) with angle-closure glaucoma, who underwent non-ciliary body detachment and were undergoing filtration surgery, were randomly selected as group B. Groups A, B2 group and according to whether the postoperative shallow anterior chamber was divided into shallow anterior chamber group (C group) and non-shallow anterior chamber group (D group). To analyze the relationship between shallow anterior chamber after cataract surgery, preoperative ciliary body detachment and intraocular pressure in patients with angle-closure glaucoma. Results There was no significant difference in all test indexes between A and B2 groups (all P> 0.05). The postoperative shallow anterior chamber in 14 cases (17 eyes), C, D group preoperative IOP were (49.90 ± 4.70) mmHg (1kPa = 7.5mmHg), (3.71 ± 3.02) mmHg; (9.75 ± 0.98) mmHg in group C and (15.76 ± 1.74) mmHg in group D, and the decrease of intraocular pressure was 38.30 ± 4.33 mmHg in group C and 19.04 ± 2.72 mmHg in group D. The difference was statistically significant All P <0.01). There was no significant difference in corneal thickness, depth of anterior chamber, the number of quadrants of trabecular iris between 0 ° and the distance of trabecular ciliary body between C group and D group (all P> 0.05) The angle between the lens (group C: 14.53 ° ± 0.44 ° and group D: 12.74 ° ± 0.70 °) had statistical significance (P <0.05). Conclusions There is no statistical correlation between the ciliary body detachment before trabeculectomy and the shallow anterior chamber after operation. The higher preoperative intraocular pressure, the greater the angle between the lens of the iris, the greater the decrease of intraocular pressure after treatment, and the lower of intraocular pressure on the first postoperative day, the greater the possibility of shallow anterior chamber.