【摘要】： 目的： 應(yīng)用光學(xué)相干斷層掃描(optical coherence tomography,OCT)觀察青光眼聯(lián)合白內(nèi)障術(shù)后黃斑中心凹視網(wǎng)膜厚度的變化。 方法： 本研究選自2009年2月至2010年2月因原發(fā)性青光眼和白內(nèi)障在湘雅醫(yī)院眼科住院的病人及醫(yī)院體檢的正常人。分為4組：A組：原發(fā)性青光眼合并白內(nèi)障的患者34例34眼,行白內(nèi)障超聲乳化聯(lián)合小梁切除術(shù)。B組：單純年齡相關(guān)性白內(nèi)障患者45例45眼,行白內(nèi)障超聲乳化術(shù)。C組：原發(fā)性青光眼患者40例48眼,行小梁切除術(shù)。D組：正常組,22例44眼。采用OCT測量A、B、C各組術(shù)前、術(shù)后1周、4周黃斑中心凹視網(wǎng)膜厚度及D組正常眼的黃斑中心凹視網(wǎng)膜厚度,并比較各組及各組間術(shù)前術(shù)后黃斑中心凹視網(wǎng)膜厚度的變化。 結(jié)果： 1.D組黃斑中心凹視網(wǎng)膜厚度為189.82±25.24 um。A、B、C各組術(shù)前黃斑中心凹視網(wǎng)膜厚度分別為196.82±41.88um、190.53±26.65um、182.75±36.86um。A、B、C、D組比較差異無統(tǒng)計學(xué)意義(P0.05)。 2.A組術(shù)前、術(shù)后1周、4周黃斑中心凹視網(wǎng)膜厚度分別為196.82±41.88um、228.79±45.73um、225.94.±41.38um。術(shù)后1周、4周同術(shù)前比較黃斑中心凹視網(wǎng)膜厚度增加,差異有統(tǒng)計學(xué)意義(p0.05)。 3.B組術(shù)前、術(shù)后1周、4周的黃斑中心凹視網(wǎng)膜厚度分別為190.53±26.65um、191.53.±26.96 um、202.40±26.11 um。術(shù)后1周、4周同術(shù)前比較黃斑中心凹視網(wǎng)膜厚度增加,僅于術(shù)后4周差異有統(tǒng)計學(xué)意義(p0.05)。 4.C組術(shù)前、術(shù)后1周、4周的黃斑中心凹視網(wǎng)膜厚度分別為182.75±36.86um、187.96±34.03um、184.17.±39.28um。術(shù)后1周、4周同術(shù)前比較黃斑中心凹視網(wǎng)膜厚度增加,差異無統(tǒng)計學(xué)意義(p0.05)。各組之間兩兩比較,A組與B組,A組與C組黃斑中心凹視網(wǎng)膜厚度有差異,差異有統(tǒng)計學(xué)意義(p0.05),B組與C組差異無統(tǒng)計學(xué)意義(P0.05)。 5.A組和C組術(shù)前眼壓與黃斑中心凹視網(wǎng)膜厚度呈正相關(guān),相關(guān)系數(shù)為(r=0.401,P=0.019和r=0.382,P=0.007)；B組術(shù)前眼壓與黃斑中心凹視網(wǎng)膜厚度無相關(guān)性,相關(guān)系數(shù)為(r=0.205,P=0.176)。 6.A組術(shù)后視力與術(shù)后1、4周黃斑中心凹視網(wǎng)膜厚度呈負(fù)相關(guān),相關(guān)系數(shù)為(r=-0.423,P=0.013；r=-0.404,P=0.018)；B組與C組術(shù)后視力與術(shù)后1、4周黃斑中心凹視網(wǎng)膜厚度無相關(guān)性,相關(guān)系數(shù)為(r=0.008,P=0.957；r=0.220,P=0.147)和(r=-0.226,P=0.123：r=-0.160,P-0.277)。 結(jié)論： 1.白內(nèi)障超聲乳化術(shù)后可導(dǎo)致黃斑中心凹視網(wǎng)膜厚度增厚,在聯(lián)合青光眼小梁切除手術(shù)時增厚更為明顯。 2.OCT是臨床上觀察青光眼聯(lián)合白內(nèi)障術(shù)后早期黃斑變化的一種簡便,快捷,無創(chuàng)傷的方法。
[Abstract]:Objective: to observe the retinal thickness of macular fovea after glaucoma and cataract surgery by optical coherence tomography (Oct). Methods: from February 2009 to February 2010, the patients admitted to Xiangya Eye Hospital for primary glaucoma and cataract and the normal subjects were studied. Group A: 34 cases (34 eyes) with primary glaucoma and cataract, group B (45 eyes) were treated with phacoemulsification combined with trabeculectomy (group B), and 45 cases (45 eyes) with age-related cataract were treated with phacoemulsification combined with trabeculectomy. Phacoemulsification was performed on 40 patients with primary glaucoma (48 eyes) and trabeculectomy group (44 eyes). The retinal thickness of macular central fovea was measured by OCT before operation, 1 week after operation and 4 weeks after operation, and the retinal thickness of macular central fovea in group D was compared before and after operation. Results: 1. The retinal thickness of macular fovea in group D was 189.82 鹵25.24 um.An, the retinal thickness of macular fovea in group D was 196.82 鹵41.88 uma, 190.53 鹵26.65um.There was no significant difference between group A and group A before operation (P0.05). The retinal thickness of macular fovea was 228.79 鹵45.73umn, 225.94 鹵41.38um. The retinal thickness of macular fovea in group B was 190.53 鹵26.65 uma, 191.53 鹵26.96 uma, 202.40 鹵26.11 uma, respectively. The retinal thickness of macular fovea increased 1 week after operation and 4 weeks after operation, only 4 weeks after operation (p0.05). The retinal thickness of macular central fovea in group C was 182.75 鹵36.86 uma 187.96 鹵34.03umn / 184.17 鹵39.28 uma before operation and 4 weeks after operation respectively. The retinal thickness of macular fovea increased 1 week and 4 weeks after operation (p 0.05). The retinal thickness of macular fovea in group A and group B was different from that in group A and group C. There was no significant difference between group B and group C (P0.05). 5. Intraocular pressure was positively correlated with retinal thickness of central fovea of macula in group A and C (r = 0.401, P = 0.019, r = 0.382, P = 0.007). There was no correlation between intraocular pressure (IOP) and retinal thickness of macular central fovea in group B (r = 0.205). In group A, postoperative visual acuity was negatively correlated with retinal thickness of macular central fovea at 1 week and the correlation coefficient was (r = 0.423). There was no correlation between the visual acuity of group B and group C and the retinal thickness of macular central fovea at 1 and 4 weeks postoperatively. The correlation coefficients were (r = 0.008) (r = 0.220) and (r = 0.226) (r = 0.123: r = 0.160 ~ (-1) P ~ (-0.277). Conclusion: 1. After phacoemulsification of cataract, the thickness of macular fovea can be thickened. 2.OCT is a simple, rapid and noninvasive method for observing the early macular changes after glaucoma and cataract surgery.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R779.6

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