Trible J R, Sergott R C, Spaeth G L, Wilson R P, Katz L J, Moster M R, Schmidt C M
Neuro-Ophthalmology Service, Wills Eye Hospital, Philadelphia 19107.
Ophthalmology. 1994 Feb;101(2):340-51. doi: 10.1016/s0161-6420(13)31332-3.
To determine whether color Doppler hemodynamic changes occur in the retrobulbar circulation after trabeculectomy.
The authors prospectively enrolled 20 patients undergoing trabeculectomy and performed color Doppler imaging of both eyes before surgery and then at approximately 2-, 5-, and 14-week intervals after surgery. The systolic maximum velocity, mean velocity, end-diastolic velocity, and vascular resistance (resistance index) of the central retinal artery, nasal and temporal short posterior ciliary arteries, and ophthalmic arteries were determined. Statistical comparison of the preoperative and postoperative measures were performed on both the operative and nonoperative eye using the paired Student's t test.
A statistically significant increase was observed in the mean and end-diastolic velocity and a significant decrease in the vascular resistance of the central retinal artery and both short posterior ciliary arteries at nearly all postoperative intervals (25 of 27 preoperative and postoperative comparisons; P < 0.05) The ophthalmic artery, while showing an increased velocity at all intervals, only attained a statistically significant increase in one of three postoperative intervals for mean velocity and two of three intervals for end-diastolic velocity (P < 0.05). There were no notable changes in resistance. The nonoperative eye did not show a statistically significant change in velocity or in resistance in the central retinal artery or either nasal or temporal short posterior ciliary artery at any interval (0 of 27 preoperative and postoperative comparisons for mean velocity, end-diastolic velocity, and resistance index.)
Sustained increases in mean velocity and end-diastolic velocity and decreases in resistance index were observed in the central retinal artery and the short posterior arteries with clinically attainable reductions in intraocular pressure after trabeculectomy in patients with chronic glaucoma. These findings are consistent with, but not diagnostic of, increased blood flow through these vessels.
确定小梁切除术后球后循环是否发生彩色多普勒血流动力学变化。
作者前瞻性纳入20例行小梁切除术的患者，在手术前及术后约2周、5周和14周对双眼进行彩色多普勒成像。测定视网膜中央动脉、鼻侧和颞侧睫状后短动脉以及眼动脉的收缩期最大速度、平均速度、舒张末期速度和血管阻力（阻力指数）。使用配对t检验对手术眼和非手术眼的术前和术后测量值进行统计学比较。
几乎在所有术后时间点，视网膜中央动脉和两条睫状后短动脉的平均速度和舒张末期速度均有统计学意义的增加，血管阻力显著降低（术前和术后比较的27组中有25组；P<0.05）。眼动脉虽然在所有时间点速度均增加，但仅在术后三个时间点中的一个时间点平均速度有统计学意义的增加，在三个时间点中的两个时间点舒张末期速度有统计学意义的增加（P<0.05）。阻力无明显变化。在任何时间点，非手术眼的视网膜中央动脉或鼻侧或颞侧睫状后短动脉的速度或阻力均无统计学意义的变化（平均速度、舒张末期速度和阻力指数的术前和术后比较的27组中均为0组）。
在慢性青光眼患者小梁切除术后，视网膜中央动脉和睫状后短动脉的平均速度和舒张末期速度持续增加，阻力指数降低，同时眼压在临床上可实现降低。这些发现与这些血管血流量增加一致，但不能作为诊断依据。
