| 摘要: |
| ［摘要］ 目的 探讨全景超声生物显微镜对高龄老年性白内障手术治疗的安全术式选择和疗效评价的意义。方法 选择该院收治的80岁以上老年性白内障患者116例（152眼），所有患者术前均经全景超声生物显微镜检查，根据患者房角关闭及狭窄程度选择白内障超声乳化联合人工晶体植入术、白内障超声乳化联合人工晶体植入及房角分离术治疗。比较术前、术后患者观察视力、房角、前房深度及眼压变化情况。结果 术后至随访终点，术前检查180°以上房角窄及<90°房角闭者房角全部开放，术前检查90°～360°房角关闭者全部开放46眼，部分开放11眼。术后平均中央前房深度（ACD）、平均房角开放度数（AA）及平均房角开放距离（AOD500）均优于术前，差异有统计学意义（P<0.01）。术后矫正视力均较术前有所提高，差异有统计学意义(P<0.01)。术后眼压均在正常范围，无高眼压及青光眼发生。结论 高龄老年性白内障患者术前进行全景超声生物显微镜检查精准定位房角异常，可指导正确手术方案制定，减少并发症发生，提高手术安全性。 |
| 关键词: 全景超声生物显微镜 房角异常 超声乳化 白内障 高龄老年人 |
| DOI：10.3969/j.issn.1674-3806.2018.04.12 |
| 分类号:R 77 |
| 基金项目: |
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| Clinical significance of panoramic ultrasound biomicroscope in surgical treatment of senile cataract |
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SONG Xue-ying, QI Shao-wen, HU Chang-e, et al.
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Department of Ophthalmology, No.152 Hospital of Chinese People′s Liberation Army, Pingdingshan 467000, China
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| Abstract: |
| ［Abstract］ Objective To explore the clinical significance of panoramic ultrasound biomicroscope in selection of operative methods and evaluation of treatment for senile cataract.Methods 152 eyes in 116 elderly patients with senile cataract were examined by panoramic ultrasound biomicroscope, and the patients were treated with phacoemulsification with intraocular lens implantation or the above surgery plus goniosynechialysis according to the existence of closure or stenosis of anterior chamber angle. The changes of anterior chamber angle, depth of anterior chamber and intraocular pressure were compared before and after surgery.Results The visual acuity of all the patients was statistiacally higher after surgery. The pre-operative visual acuity was higher than 0.3 in 0 eye(0.00%), 0.1～0.3 in 46 eyes(30.26%) and lower than 0.1 in 106 eyes(69.74%). After surgery, the visual acuity was improved, higher than 0.3 in 100 eyes(higher than 0.5 in 53 eyes), between 0.1～0.3 in 39 eyes，and lower than 0.1 in 13 eyes. The mean intraocular pressure was (15.69±5.68)mmHg before surgery and (13.02±3.47)mmHg after surgery(P>0.05). The anterior chamber angles of all eyes became significantly wider after surgery. The mean anterior chamber depth was (1.94±0.33)mm pre-operatively and (3.45±0.27)mm(P<0.05) post-operatively. The mean angle of central anterior chamber(AA) was (21.63±5.65)° before surgery and (33.01±5.64)° after surgery(P<0.05). The mean anterior chamber angle open depth(AOD500) was (331±135)μm before operation and (516±123)μm(P<0.01) after operation.Conclusion Pre-operative application of panoramic ultrasound biomicroscope helps to locate the abmormal anterior chamber angle, direct the plan of surgery, reduce the complications and enhance the safety in treatment of cataract in elderly patients. |
| Key words: Panoramic ultrasound biomicroscope Abnormal anterior chamber angle Phacoemulsification Cataract Elderly people |
