不同类型人工晶体植入术后前房形态变化及意义

Anterior chamber change and significance after different type artificial lens implantation

关键词:  人工晶体  超声生物显微镜  前房

Key words:  [Key words]　artificial lens  ultrasound biomicroscoPy (UBM)  anterior chamber

摘要:

目的　探讨不同类型人工晶体植入术后前房形态的变化规律。　方法　　选择60例（87只眼）2007年-2010年间皮质型老年性白内障患者，按Chylack分期均为皮质型Ⅲ期。随机分成3组，A组为植入三片式（Senser）人工晶体组、B组为植入一片式（Natural）人工晶体组、C组为植入一片式（Rayner）体积较大组。均行超声乳化白内障吸除联合折叠式人工晶状体植入术，分别于术前和术后3个月用超声生物显微镜(UBM)量化测量前房深度和前房角宽度变化，观察人工晶体位置。　结果　　（1）A、B、C 3组术前中央前房深度（ACD）、房角开放距离-500 μm处 (AOD500)、房角开放距离-250 μm 处(AOD250)、小梁虹膜夹角(TIA500)与术后3个月比较均明显增大，差异均有显著性意义(P<0.05)。（2）术后3个月时，3组间ACD：A组及B组变化大于C组(P<0.05)，A组与B组间无明显差异(P>0.05)。500 μm处小梁虹膜夹角A组及B组变化也明显大于C组(P<0.05)，A组与B组间无明显差异。250 μm处前房角开放距离在3组间均无明显差异。500 μm处前房角开放距离A组与其他两组比较差异明显(P<0.05),B组与C组无明显差异(P>0.05)。　结论　　超声乳化白内障吸除联合折叠式人工晶状体植入术后的前房与术前相比，前房明显加深，房角明显加宽。三片式（PMMA襻 拱5°夹角）对中央前房深度影响较大，对于闭角型青光眼预防及治疗效果最佳。

Abstract:

[Abstract] Objective　To explore the morphological changes of anterior chamber after the different types of artificial lens implantation. 　Methods　Sixty patients with senile cataract patients (87 eyes) cortex press Chylack Classification System Ⅲ were selected during 2007 to 2010. Patients were randomly divided into 3 groups, group A three panel (Senser) implanted intraocular lens group, the group B implant A chip (Natural) artificial lens group, group C to implant A chip (Rayner) larger group. Were performed phacoemulsification cataract gettering, foldable intraocular lens (iol) implantation in ultrasound preoperative and postoperative 3 months with the quantitative measurement of biological microscope anterior chamber depth and width of the anterior chamber Angle, observation of artificial lens. 　Results (1) A，B and C group of preoperative central anterior chamber depth (ACD), the Angle open distance (AOD500), the Angle open distance (AOD250), the trabecular iris Angle (TIA500) were increased significantly than 3 months after operation (P<0.05). (2) 3 months after operation, the ACD between three groups: A and B groups were greater than C group (P<0.05), no significant differences between group A and group B (P>0.05). 500 μm trabecular iris Angle between group A and group B was significantly greater than group C (P<0.05). 250 μm angle opening distance among the three groups were not significantly different. 500 μm angle opening distance in the A group and other two groups significant difference(P<0.05), B and C group no significant difference. 　Conclusion Ultrasonic emulsification cataract gettering after anterior chamber foldable intraocular lens (iol) implantation in compared with the preoperative, obviously deepened, anterior chamber Angle significantly broadened. Three chip (PMMA arch 5°Angle) to the anterior chamber depth, so for the prevention and treatment of primary closed-angle glaucoma effect is best.