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[超声乳化白内障吸除术预防急性闭角型青光眼发作]

[Phacoemulsification in prevention of acute angle-closure glaucoma attack].

作者信息

Sorokin E L, Marchenko A N, Pashentsev Ya E

机构信息

Khabarovsk branch of S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery»», Khabarovsk, Russia.

Far-Eastern State Medical University, Khabarovsk, Russia.

出版信息

Vestn Oftalmol. 2022;138(2):37-46. doi: 10.17116/oftalma202213802137.

Abstract

UNLABELLED

Analysis of the effectiveness of preventative phacoemulsification (PE) in anatomically short eyes with an increased risk of an acute glaucoma attack in thickened lens can help in choosing the optimal management tactics for these patients.

PURPOSE

To study the changes in morphometric parameters of the anterior segment of anatomically short eyes with an increased risk of acute glaucoma attack before and after preventative PE.

MATERIAL AND METHODS

The study included 70 patients (70 eyes) with a high risk of acute glaucoma attack in short anatomical axial length and thickened lens, with posterior and middle positions of the ciliary body. They were divided into 2 groups: the main group consisted of 45 patients who agreed to undergo PE; the comparison group consisted of 25 patients who refused to undergo PE due to good visual functions and no complaints about vision. B-mode ultrasound examination of the anterior segment of the eye was used to evaluate the cross-sectional surface area of the lens (CSAL) and the cross-sectional surface area of the anterior chamber (CSAAC).

RESULTS

In the main group, on day 2-3 after PE the anterior chamber depth increased in all eyes, the CSAAC index increased, the anterior chamber angle (ACA) widened to Schaffer grade to II-III. After 1-3 years and 4-5 years, the anterior chamber depth, the CSAAC index and the width of the ACA remained stable. In the comparison group, after 1-3 years the anterior chamber depth and the CSAAC index significantly decreased, the ACA narrowed, and the intraocular pressure increased; after 4-5 years, there was a progressive increase in the CSAL index, the ACA was completely closed (0°).

CONCLUSION

In all cases of timely performed preventative PE, already on days 2-3 after surgery there was a statistically significant improvement in the main morphometric parameters of the eye, which remained stable for 4-5 years.

摘要

未标注

分析预防性超声乳化术(PE)对解剖学上短眼且增厚晶状体急性青光眼发作风险增加的有效性,有助于为这些患者选择最佳治疗策略。

目的

研究预防性PE前后解剖学上短眼且急性青光眼发作风险增加的眼前节形态学参数的变化。

材料与方法

该研究纳入70例患者(70只眼),其解剖学眼轴短且晶状体增厚,睫状体处于后位和中位,急性青光眼发作风险高。他们被分为2组:主要组由45例同意接受PE的患者组成;比较组由25例因视力良好且无视力相关主诉而拒绝接受PE的患者组成。使用眼部B超检查眼前节,以评估晶状体横截面积(CSAL)和前房横截面积(CSAAC)。

结果

主要组中,PE后第2 - 3天,所有眼的前房深度增加,CSAAC指数增加,前房角(ACA)增宽至Shaffer分级II - III级。1 - 3年和4 - 5年后,前房深度、CSAAC指数和ACA宽度保持稳定。比较组中,1 - 3年后前房深度和CSAAC指数显著降低,ACA变窄,眼压升高;4 - 5年后CSAL指数逐渐增加,ACA完全闭合(0°)。

结论

在所有及时进行预防性PE的病例中,术后第2 - 3天眼部主要形态学参数即有统计学意义的改善,并在4 - 5年内保持稳定。

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