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非青光眼眼中白内障手术后前节形态和眼内压的变化。

Changes in Anterior Segment Morphology and Intraocular Pressure after Cataract Surgery in Non-glaucomatous Eyes.

机构信息

Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.

Ophthalmology Clinic, Department of Medicine and Science of Ageing, University "G. D'Annunzio" of Chieti Pescara, Chieti, Italy.

出版信息

Klin Monbl Augenheilkd. 2023 Apr;240(4):449-455. doi: 10.1055/a-2013-2374. Epub 2023 Apr 25.

Abstract

BACKGROUND

It is known that cataract extraction is associated with a significant reduction in intraocular pressure, especially in narrow angled eyes; however, the modifications of anterior segment parameters associated with this phenomenon have still not been completely defined. The purpose of this study was to evaluate changes in anterior segment anatomy and intraocular pressure after cataract surgery in non-glaucomatous eyes.

METHODS AND MATERIAL

This retrospective case series study included 64 eyes of 64 consecutive patients who underwent phacoemulsification with intraocular lens implantation. Anterior segment parameters and intraocular pressure were assessed and compared before and 6 months after surgery. Anterior segment imaging was performed using Casia SS-1000 anterior segment optical coherence tomography (Tomey, Nagoya, Japan). Anterior segment measurements included anterior chamber depth, anterior chamber width, anterior chamber volume, angle opening distance at 500 µm anterior to the scleral spur, angle recess area 750 µm from the scleral spur, lens vault, trabecular iris space area at 500 µm from the scleral spur, and trabecular iris angle at 500 µm from the scleral spur. Intraocular pressure was measured using the Goldmann applanation tonometer (Model AT 900 C/M, Haag-Streit, Bern, Switzerland). Anterior segment parameters and the relationship of changes in intraocular pressure were also evaluated.

RESULTS

All anterior segment parameters increased significantly after surgery (p < 0.05). Both angle opening distance at 500 µm anterior to the scleral spur and anterior chamber depth changes were positively correlated with the preoperative lens vault. The mean intraocular pressure significantly decreased from 14.91 mmHg (± 2.8 SD) to 12.91 mmHg (± 3.13 SD) (p < 0.001). Changes in intraocular pressure correlated negatively with values for the width of the preoperative anterior chamber (r = - 0.533; p = 0.001).

CONCLUSION

Cataract surgery led to significant widening of the anterior chamber angle and lowering of intraocular pressure. Further investigations are needed to better understand whether anterior chamber width may be a new independent predictive factor for reduction in postoperative intraocular pressure.

摘要

背景

已知白内障摘除术会显著降低眼内压,尤其是在窄角眼;然而,与这一现象相关的前节参数的变化仍未完全确定。本研究旨在评估非青光眼眼中白内障手术后前节解剖结构和眼内压的变化。

方法和材料

本回顾性病例系列研究纳入了 64 例(64 只眼)连续接受白内障超声乳化吸除联合人工晶状体植入术的患者。在术前和术后 6 个月评估并比较前节参数和眼内压。使用 Casia SS-1000 眼前节光学相干断层扫描仪(Tomey,名古屋,日本)进行眼前节成像。眼前节测量包括前房深度、前房宽度、前房容积、巩膜突前 500μm 处房角开放距离、巩膜突后 750μm 处房角隐窝面积、晶状体厚度、巩膜突后 500μm 处小梁虹膜空间面积和巩膜突后 500μm 处小梁虹膜角度。使用 Goldmann 压平眼压计(Model AT 900 C/M,Haag-Streit,伯尔尼,瑞士)测量眼内压。还评估了眼前节参数与眼内压变化的关系。

结果

所有眼前节参数在术后均显著增加(p<0.05)。巩膜突前 500μm 处房角开放距离和前房深度的变化与术前晶状体厚度呈正相关。平均眼内压从 14.91mmHg(±2.8SD)显著降低至 12.91mmHg(±3.13SD)(p<0.001)。眼内压的变化与术前前房宽度呈负相关(r=-0.533;p=0.001)。

结论

白内障手术后前房角明显增宽,眼内压降低。需要进一步研究以更好地了解前房宽度是否可能成为术后眼内压低的新的独立预测因素。

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