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[局部麻醉下白内障手术中眼球压迫对前房尺寸的影响]

[Effect of ocular compression on anterior chamber dimensions in cataract surgery using topical anaesthesia].

作者信息

Wirbelauer C, Pham D T

机构信息

Augenklinik Berlin-Marzahn, Berlin.

Klinik für Augenheilkunde, Vivantes Klinikum Neukölln, Berlin.

出版信息

Klin Monbl Augenheilkd. 2014 Oct;231(10):999-1003. doi: 10.1055/s-0034-1383069. Epub 2014 Oct 21.

Abstract

PURPOSE

Ocular compression is part of the preparation before cataract surgery to reduce the incidence of a positive intraoperative pressure. The purpose of this clinical study was to assess the influence of ocular compression on the anterior chamber dimensions and biometric parameters before cataract surgery using topical anaesthesia.

METHODS

In a prospective, comparative observational study the biometric parameters were assessed with slitlamp-adapted anterior segment OCT (SL-OCT, Heidelberg Engineering) and ultrasound biometry (A-Scan+, Sonomed) in 51 consecutive patients (51 eyes) with a mean axial eye length of 22.90 ± 1.05 mm before cataract surgery. The measurements were performed in all patients before and immediately after ocular compression (Oculopressor G-15392, Geuder). In 32 patients the measurements were repeated 10 minutes after ocular compression.

RESULTS

The optical and acoustic values of the anterior chamber depth did not change significantly after ocular compression (p > 0.05). Digital gonioscopy with OCT revealed a mean increase of the anterior chamber angle of 2.37° (p < 0.001) from 45.75 ± 7.28° to 48.12 ± 7.28°, and the angle opening distance of 37 µm (p = 0.017) from 627 ± 184 µm to 664 ± 162 µm. Also the average acoustic axial vitreous distance decreased significantly from 15.22 ± 0.98 to 15.18 ± 0.96 mm (p = 0.034) with a posterior shift in the relative lens position (p = 0.018).

CONCLUSIONS

In this clinical study, only slight anterior chamber and biometric changes were observed after ocular compression before cataract surgery using topical anaesthesia. There was a significant increase of the anterior chamber angle and angle opening distance with a concomitant decrease of the vitreous distance and shifting of the iris lens diaphragm.

摘要

目的

眼球压迫是白内障手术前准备工作的一部分,旨在降低术中眼压为正的发生率。本临床研究的目的是评估在表面麻醉下白内障手术前眼球压迫对前房尺寸和生物测量参数的影响。

方法

在一项前瞻性、对比观察性研究中,使用裂隙灯适配的眼前节光学相干断层扫描(SL-OCT,海德堡工程公司)和超声生物测量法(A-Scan+,索诺美公司)对51例连续患者(51只眼)进行生物测量参数评估,这些患者白内障手术前平均眼轴长度为22.90±1.05毫米。所有患者在眼球压迫(Oculopressor G-15392,格德公司)前和压迫后立即进行测量。32例患者在眼球压迫10分钟后重复测量。

结果

眼球压迫后前房深度的光学和声学值无显著变化(p>0.05)。光学相干断层扫描数字前房角镜检查显示,前房角平均增加2.37°(p<0.001),从45.75±7.28°增至48.12±7.28°,房角开放距离增加37微米(p=0.017),从627±184微米增至664±162微米。此外,平均声学眼轴玻璃体距离从15.22±0.98显著降至15.18±0.96毫米(p=0.034),晶状体相对位置向后移位(p=0.018)。

结论

在本临床研究中,表面麻醉下白内障手术前眼球压迫后仅观察到轻微的前房和生物测量变化。前房角和房角开放距离显著增加,同时玻璃体距离减小,虹膜晶状体膈移位。

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