目的：利用超声生物显微镜(UBM)结合A超定量测量老年人可疑房角关闭眼的眼前段生物学参数，探讨老年人发生急性房角关闭的潜在解剖因素以利青光眼的早期预防。

方法：回顾性分析年龄55～83岁临床诊断为可疑房角关闭患者33例35眼。随机选取年龄55～80岁的健康志愿者25例25眼作为对照组。应用UBM测量两组的中央前房深度(ACD)，房角开放距离500(AOD₅₀₀)，虹膜晶状体接触距离(ILCD)，小梁睫状体距离(TCPD)，睫状体绕巩膜突向前旋转角度(B角)，虹膜厚度(IT)。应用A超测量两组的晶状体厚度(LT)，眼轴长度(AL)。并计算出晶状体相对位置(RLP)。

结果：老年人可疑房角关闭眼与正常对照组相比，晶状体相关参数：RLP明显偏前(P<0.01)，LT增加(P<0.05)，ILCD增加(P<0.01)，差异具有统计学意义； 睫状体相关参数：TCPD，B角明显减小(P<0.01)，差异具有统计学意义； 前房相关参数：ACD ，AOD₅₀₀明显减小(P<0.01)，差异具有统计学意义； 虹膜参数：IT基本无差异(P>0.05)。

结论：老年人发生急性房角关闭的危险因素是晶状体位置厚度的改变，并且存在有睫状体位置的前移前旋。

AIM: To investigate the potential dissect element of elderly acute primary angle closure for early glaucoma prevention by measuring the parameters of anterior eye segment in the elderly with primary angle closure using ultrasound biomicroscopy(UBM)and A-scan ultrasonography.

METHODS: A retrospective study was performed based on the measured parameters with two samples. The first sample included 35 primary angle closure suspect eyes of 33 patients aging from 55 to 83 years old and the second sample included 25 healthy eyes of 25 randomly selected volunteers aging from 55 to 80 years old. The anterior chamber depth(ACD), angle opening distance(AOD500), iris-lens contract distance(ILCD),trabecular-ciliary process distance(TCPD), the ciliary processes around the scleral forward rotation angle(B angle),iris thickness(IT)were measured by UBM. Axial length(AL), lens thickness(LT), relative lens position(RLP)were measured by A-scan ultrasonography.

RESULTS: We compared the parameters measured for 35 primary angle closure suspect eyes and 25 healthy eyes. For Crystal related parameters, the RLP of angle closure suspect eyes decreased significantly(P<0.01)from that of healthy eyes, the LT of angle closure suspect eyes increased significantly(P<0.05)from that of healthy eyes, the ILCD of angle closure suspect eyes increased significantly(P<0.01)from that of healthy eyes; For ciliary body parameters, the TCPD, B angle of angle closure suspect eyes decreased significantly(P<0.01)from that of healthy eyes; For anterior chamber associated parameters, the ACD, AOD500 of angle closure suspect eyes decreased significantly(P<0.01)from that of healthy eyes. However, there was no difference in IT between the primary angle closure suspect eyes and the healthy eyes.

CONCLUSION: Lens forward positioning, lens thickness increase, and ciliary body position forward swing are high risk factors of elderly acute primary angle closure.

上海市宝山区科学技术委员会课题资助项目(No.09-E-11); 上海市卫生局重点专科建设资助项目(No.ZK2012A03); 上海曙光医院宝山分院中西医结合重点专科资助项目(No.ZXYZK201001)