目的:探讨利用Pentacam三维眼前节分析诊断系统观察年龄相关性白内障患者超声乳化手术前后前房容积(anteriorchamber volume,ACV)、前房深度(anterior chamber depth,ACD)、前房角(anterior chamber angle,ACA)的变化。方法:临床选取2007-10/2009-05在本院眼科中心行超声乳化吸除折叠型人工晶状体(intraocular lens,IOL)植入手术的年龄相关性白内障患者200例220眼,闭角型青光眼病史及其他眼疾的患者排除。对全部患者应用Pentacam分别测量术前、术后1,6mo的ACV,ACD和ACA(鼻侧,颞侧,上方,下方),Goldmann压平眼压计测量各期眼内压(intraocular pressure,IOP)。应用t检验和one-wayANOVA数据分析,并应用Pearson相关分析IOP与ACV,ACD,ACA之间关系。结果:术前ACV,ACD,ACA,IOP依次为152.25±39.87mm3,2.86±0.55mm,28.56°±4.87°,15.54±2.23mmHg;术后1mo,ACV,ACD,ACA,IOP依次为189.65±36.73mm3,4.02±0.53mm,39.72°±5.02°,13.02±1.97mmHg;术后6mo,ACV,ACD,ACA,IOP依次为191.47±33.79mm3,4.01±0.38mm,42.02°±5.98°,12.76±1.52mmHg。ACV,ACD及鼻侧,颞侧,上方,下方4个象限的ACA在术后1,6mo均较术前显著增大,眼压显著下降,差异有统计学意义;术后6mo与1mo相比,差异无统计学意义。结论:Pentacam系统检查手术前后眼前节为非接触性,自动快速易操作。Pentacam测量年龄相关性白内障超声乳化吸除联合折叠型IOL植入术后1,6mo ACV,ACD均增大,4个象限ACA均增大,同时伴有眼压显著下降。术后6mo与1mo基本无差异。

AIM:To quantify the changes in the anterior chamber volume(ACV),anterior chamber depth(ACD) and anterior chamber angle(ACA) measurements obtained by the Pentacam rotating Scheimpflug camera following phacoemulsification surgery in age-related cataract eyes.METHODS:Totally 220 eyes of 200 age-related cataract patients who underwent cataract extraction between October 2007 and May 2009 were selected.Patients with a history of angle-closure glaucoma or any other ocular diseases were excluded.Intraocular pressure(IOP) measurement was performed using Goldmann applanation tonometer(GAT).The parameters including ACV,ACD and inferior,superior,temporal and nasal ACA measurements were obtained using the Pentacam system before and 1 month and 6 months after phacoemulsification and intraocular lens(IOL) implantation.Data were compared using paired t-test and one-way ANOVA.The relationships between IOP and ACV,ACD or ACA were analyzed using Pearson correlation analysis.RESULTS:Mean preoperative ACV,ACD,ACA and IOP measurements were 152.25±39.87mm3,2.86±0.55mm,28.56°±4.87°,15.54±2.23mmHg respectively.One month postoperatively,mean ACV,ACD,ACA and IOP measurements were 189.65±36.73mm3,4.02±0.53mm,39.72°±5.02°,13.02±1.97mmHg,respectively.Six months postoperatively,mean ACV,ACD,ACA and IOP measurements were 191.47±33.79 mm3,4.01±0.38mm,42.02°±5.98°,12.76±1.52mmHg,respectively.Postoperative mean ACV,ACD and ACA value in all four quadrants were significantly increased both at 1month and 6 months postoperatively(P<0.01,P<0.01,P<0.01),and IOP was significantly reduced(P<0.01).There was no significant difference between 1 month and 6 months postoperatively.CONCLUSION:The Pentacam system is automatic,easy,fast,and non-contact when used for the anterior chamber parameters pre-and postoperatively in all patients’ eyes.Measurements obtained confirm that in age-related cataract eyes,the ACV and ACD increase and the ACA widens in all four quadrants 1 month and 6 months after phacoemulsification and foldable IOL implantation.These changes accompany with a significant fall in IOP.There are no significant changes between 6 months and 1 month postoperatively.

R776.1

中国上海市重点学科建设资助项目(No.S30205)