【摘要】：目的：通過Pentacam綜合眼前節(jié)三維分析系統(tǒng)測量正常人和原發(fā)性閉角型青光眼(primary angle-closure glaucoma, PACG)患者的前房形態(tài)參數(shù)：前房深度(anterior chamber depth, ACD)、前房容積(anterior chambervolume，ACV)、前房夾角(anterior chamber angle，ACA)。尋求原發(fā)性閉角型青光眼的早期篩查方法；應(yīng)用Pentacam綜合眼前節(jié)三維分析系統(tǒng)測量原發(fā)性急性閉角型青光眼臨床前期眼和原發(fā)性慢性閉角型青光眼對側(cè)眼YAG激光周邊虹膜切開術(shù)前、術(shù)后前房形態(tài)參數(shù)變化，尋找前房形態(tài)變化的敏感指標(biāo)并評價(jià)YAG激光周邊虹膜切開術(shù)的療效。 方法：1正常對照組25眼與原發(fā)性急性閉角型青光眼緩解期25眼、原發(fā)性慢性閉角型青光眼25眼、原發(fā)性急性閉角型青光眼臨床前期25眼、原發(fā)性慢性閉角型青光眼對側(cè)眼25眼，應(yīng)用Pentacam綜合眼前節(jié)三維分析系統(tǒng)測量前房形態(tài)參數(shù)：前房深度(anterior chamber depth,ACD)、前房容積(anterior chamber volume，ACV)、前房夾角(anterior chamberangle，ACA)。2應(yīng)用Pentacam綜合眼前節(jié)三維分析系統(tǒng)測量原發(fā)性急性閉角型青光眼臨床前期眼患者YAG激光周邊虹膜切開術(shù)前與術(shù)后1天、7天、28天的前房形態(tài)參數(shù)：前房深度(anterior chamber depth, ACD)、前房容積(anterior chamber volume，ACV)、前房夾角(anterior chamber angle，ACA)。3應(yīng)用Pentacam綜合眼前節(jié)三維分析系統(tǒng)測量原發(fā)性慢性閉角型青光眼患者對側(cè)眼YAG激光周邊虹膜切開術(shù)前與術(shù)后1天、7天、28天的前房形態(tài)參數(shù)：前房深度(anterior chamber depth, ACD)、前房容積(anterior chamber volume，ACV)、前房夾角(anterior chamber angle，ACA)。4計(jì)算原發(fā)性急性閉角型青光眼臨床前期眼YAG激光周邊虹膜切開術(shù)后前房形態(tài)參數(shù)的變化：術(shù)后28天測量的前房形態(tài)參數(shù)值－術(shù)前測量的前房形態(tài)參數(shù)值；計(jì)算原發(fā)性慢性閉角型青光眼對側(cè)眼YAG激光周邊虹膜切開術(shù)后前房形態(tài)參數(shù)的變化：術(shù)后28天測量的前房形態(tài)參數(shù)值－術(shù)前測量的前房形態(tài)參數(shù)值。 結(jié)果：1正常對照組與原發(fā)性急性閉角型青光眼緩解期、原發(fā)性慢性閉角型青光眼、原發(fā)性急性閉角型青光眼臨床前期、原發(fā)性慢性閉角型青光眼對側(cè)眼比較，正常對照組前房形態(tài)三種參數(shù)的測量值均大于其他各組，差異均有統(tǒng)計(jì)學(xué)意義(P 0.05)。原發(fā)性閉角型青光眼各組之間比較，差異無統(tǒng)計(jì)學(xué)意義。2原發(fā)性急性閉角型青光眼臨床前期眼YAG激光周邊虹膜切開術(shù)后各時(shí)間點(diǎn)前房深度較術(shù)前加深，前房容積較術(shù)前變大，差異有統(tǒng)計(jì)學(xué)意義（P 0.05），前房夾角值與術(shù)前比較，差異無統(tǒng)計(jì)學(xué)意義，，術(shù)后1天、7天、28天的前房深度值、前房容積值、前房夾角值比較，差異均無統(tǒng)計(jì)學(xué)意義。3原發(fā)性慢性閉角型青光眼患者對側(cè)眼YAG激光周邊虹膜切開術(shù)后各時(shí)間點(diǎn)前房深度較術(shù)前加深，前房容積較術(shù)前變大，差異有統(tǒng)計(jì)學(xué)意義（P 0.05）；前房夾角值與術(shù)前比較，差異無統(tǒng)計(jì)學(xué)意義，術(shù)后7天、28天與術(shù)后1天的前房深度、前房容積比較，差異有統(tǒng)計(jì)學(xué)意義（P 0.05）；術(shù)后7天、28天的前房深度、前房容積比較，差異無統(tǒng)計(jì)學(xué)意義。術(shù)后各時(shí)間點(diǎn)前房夾角值比較，差異無統(tǒng)計(jì)學(xué)意義。4原發(fā)性急性閉角型青光眼臨床前期患者YAG激光周邊虹膜切開術(shù)后前房深度增加值（術(shù)后28天前房深度-術(shù)前前房深度）、前房容積增加值(術(shù)后28天前房容積-術(shù)前前房容積)較原發(fā)性慢性閉角型青光眼患者對側(cè)眼顯著增大，差異有統(tǒng)計(jì)學(xué)意義 結(jié)論：1Pentacam綜合眼前節(jié)三維分析系統(tǒng)測量前房形態(tài)參數(shù)可以為原發(fā)性閉角型青光眼患者的篩查和早期診斷提供依據(jù)。2Pentacam綜合眼前節(jié)三維分析系統(tǒng)可以用來量化評價(jià)YAG激光周邊虹膜切開術(shù)后的眼前節(jié)形態(tài)的變化，為預(yù)后的評估提供參考。
[Abstract]:Objective: To investigate the anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA) in normal subjects and patients with primary angle-closure glaucoma (PACG) by Pentacam three-dimensional analysis system. Early screening for primary angle-closure glaucoma; Pentacam integrated anterior segment three-dimensional analysis system was used to measure the morphological parameters of anterior chamber before and after YAG laser peripheral iridotomy in primary acute angle-closure glaucoma and primary chronic angle-closure glaucoma. Objective to evaluate the efficacy of YAG laser peripheral iridotomy.
Methods: 1 25 eyes of normal control group, 25 eyes of primary acute angle closure glaucoma in remission stage, 25 eyes of primary chronic angle closure glaucoma, 25 eyes of primary acute angle closure glaucoma in preclinical stage, 25 eyes of primary chronic angle closure glaucoma in contralateral stage, and 25 eyes of primary chronic angle closure glaucoma in remission stage were measured by Pentacam three-dimensional analysis system. Anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA) were measured by Pentacam three-dimensional analysis system before and 1, 7, 28 days after YAG laser peripheral iridotomy in patients with primary acute angle-closure glaucoma. PARAMETERS: Anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA). 3 Pentacam integrated anterior segment three-dimensional analysis system was used to measure the contralateral YAG laser peripheral iridotomy in patients with primary chronic angle-closure glaucoma before and 1, 7, 28 days after surgery. Anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA). 4. Changes of anterior chamber shape parameters after YAG laser peripheral iridectomy in primary acute angle-closure glaucoma: Anterior chamber shape parameters measured 28 days after surgery Value-Preoperative measurement of anterior chamber shape parameters; Computation of primary chronic angle-closure glaucoma contralateral YAG laser peripheral iridectomy anterior chamber shape parameters changes: 28 days after the measurement of anterior chamber shape parameters-preoperative measurement of anterior chamber shape parameters.
Results: 1 Compared with the contralateral eyes of primary acute angle-closure glaucoma, primary chronic angle-closure glaucoma, primary acute angle-closure glaucoma and primary chronic angle-closure glaucoma, the measurement values of the three parameters of anterior chamber morphology in the normal control group were higher than those in the other groups. There was no significant difference between the groups of primary angle-closure glaucoma (P 0.05). 2 The depth of anterior chamber was deeper and the volume of anterior chamber was larger at each time point after YAG laser peripheral iridotomy in primary acute angle-closure glaucoma (P 0.05). There was no significant difference in the anterior chamber depth, anterior chamber volume and anterior chamber angle at 1, 7 and 28 days after surgery. 3 The anterior chamber depth and anterior chamber volume increased at different time points after YAG laser peripheral iridotomy in the contralateral eyes of patients with primary chronic angle-closure glaucoma. Significance (P 0.05); Angle between anterior chamber and preoperative, no significant difference, postoperative 7 days, 28 days and postoperative 1 day of anterior chamber depth, anterior chamber volume, the difference was statistically significant (P 0.05); postoperative 7 days, 28 days of anterior chamber depth, anterior chamber volume, no significant difference. Statistical significance.4 In primary acute angle-closure glaucoma, the increase of anterior chamber depth (anterior chamber depth-preoperative anterior chamber depth 28 days after YAG laser peripheral iridotomy) and anterior chamber volume (anterior chamber volume-preoperative anterior chamber volume 28 days after surgery) were significantly larger and worse than those in primary chronic angle-closure glaucoma. The difference was statistically significant.
Conclusion: 1 Pentacam integrated anterior segment three-dimensional analysis system can provide a basis for screening and early diagnosis of primary angle-closure glaucoma. 2 Pentacam integrated anterior segment three-dimensional analysis system can be used to quantify the changes of anterior segment morphology after YAG laser peripheral iridectomy, and to evaluate the prognosis. Provide reference.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R779.6

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