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高度近视白内障术后早期眼压升高患者的施累姆管和小梁网特征。

Schlemm Canal and Trabecular Meshwork Features in Highly Myopic Eyes With Early Intraocular Pressure Elevation After Cataract Surgery.

机构信息

Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital of Fudan University, Shanghai, People's Republic of China; Key Laboratory of Myopia, Ministry of Health, People's Republic of China; Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, People's Republic of China; Shanghai High Myopia Study Group, Shanghai, People's Republic of China; Visual Rehabilitation Professional Committee, Chinese Association of Rehabilitation Medicine, Shanghai, People's Republic of China.

Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital of Fudan University, Shanghai, People's Republic of China; Key Laboratory of Myopia, Ministry of Health, People's Republic of China; Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, People's Republic of China; Shanghai High Myopia Study Group, Shanghai, People's Republic of China; Visual Rehabilitation Professional Committee, Chinese Association of Rehabilitation Medicine, Shanghai, People's Republic of China.

出版信息

Am J Ophthalmol. 2020 Aug;216:193-200. doi: 10.1016/j.ajo.2020.02.005. Epub 2020 Feb 14.

Abstract

PURPOSE

To investigate the morphologic features of the Schlemm canal and trabecular meshwork in highly myopic eyes with early intraocular pressure (IOP) elevation after cataract surgery.

DESIGN

Retrospective case-control study.

METHODS

Eighty-eight highly myopic eyes of 88 patients after uneventful cataract surgery were included, 31 of which had early postoperative IOP elevation and 57 of which did not. The morphologic features of the Schlemm canal and trabecular meshwork, collected with swept-source optical coherence tomography before surgery, were reviewed. Backwards stepwise multiple linear regression was used to investigate the anatomic risk factors for early IOP elevation in highly myopic eyes.

RESULTS

Highly myopic eyes with early postoperative IOP elevation had smaller Schlemm canal vertical diameter and area, as well as smaller trabecular meshwork thickness and width, in each quadrant than the non-elevation group. There was no significant difference in Schlemm canal horizontal diameter between the IOP elevation and non-elevation groups. In the highly myopic eyes, average Schlemm canal vertical diameter, Schlemm canal area, trabecular meshwork thickness, and width were all correlated negatively with the IOP elevation. A multivariate analysis showed that average Schlemm canal vertical diameter (β = -0.262, P = .004) and trabecular meshwork thickness (β = -0.173, P < .001) were significantly associated with early transient IOP elevation in highly myopic cataract eyes.

CONCLUSIONS

A smaller vertical diameter of Schlemm canal and a thinner trabecular meshwork are 2 anatomic risk factors for early IOP elevation after cataract surgery in highly myopic eyes.

摘要

目的

研究白内障手术后早期眼压升高的高度近视眼中施累姆管和小梁网的形态特征。

设计

回顾性病例对照研究。

方法

纳入 88 例白内障手术顺利的高度近视患者的 88 只眼,其中 31 只眼术后早期眼压升高,57 只眼眼压不升高。术前应用扫频源光学相干断层扫描仪采集施累姆管和小梁网的形态学特征,应用逐步后退多元线性回归分析高度近视眼早期眼压升高的解剖学危险因素。

结果

术后早期眼压升高的高度近视眼中,每个象限的施累姆管垂直直径和面积较小,小梁网厚度和宽度较小。IOP 升高组与非升高组的施累姆管水平直径无显著差异。在高度近视眼中,平均施累姆管垂直直径、施累姆管面积、小梁网厚度和宽度均与眼压升高呈负相关。多因素分析显示,平均施累姆管垂直直径(β=-0.262,P=0.004)和小梁网厚度(β=-0.173,P<0.001)与高度近视白内障眼术后早期短暂眼压升高显著相关。

结论

施累姆管垂直直径较小和小梁网较薄是高度近视眼白内障术后早期眼压升高的 2 个解剖学危险因素。

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