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目的 探讨视网膜光凝术对糖尿病视网膜病变 (diabeticretinopathy ,DR)患者眼前段的早期影响。方法 应用超声生物显微镜观察和定量分析 36例 (36只眼 )DR患者视网膜光凝术前 ,术后第 3d和第 7d前房深度、前房角、睫状体及前段脉络膜的改变。结果 与术前比较 ,光凝术后第 3d患眼眼压平均升高 (0 933± 1 985 )mmHg(1mmHg =0 133kPa) (t =2 82 1,P <0 0 1) ;上、下、颞侧前房角变窄 (t =2 0 33～ 3 15 0 ,P <0 0 5 ) ,前房轻度变浅 (t =1 793,P >0 0 5 )。2 9只眼 (80 6 % )同时发生了睫状体和前段脉络膜脱离 ,3只眼发生了单纯的睫状体或前段脉络膜脱离。上方象限睫状体脱离高度 >其他象限 (F =7 44 ,P =0 0 0 0 )。1例患者睫状体和脉络膜脱离持续至术后第 14d ,其余患眼睫状体和脉络膜脱离于术后第 7d自行消退。睫状体和脉络膜脱离的高度与年龄呈显著正相关 ,而与空腹血糖、糖尿病病程及DR病程无明显相关关系。结论 视网膜光凝术可引起DR眼早期眼压升高、前房角变窄、睫状体和脉络膜脱离等眼前段改变 ,年龄是影响睫状体和脉络膜脱离严重程度的因素之一。
Objective To investigate the early effects of retinal photocoagulation on the anterior segment of diabetic retinopathy (DR). Methods The changes of anterior chamber depth, anterior chamber angle, ciliary body and anterior choroid were observed before and 3 and 7 days after retinal photocoagulation in 36 patients (36 eyes) with ultrasound biomicroscopy. Results Compared with the preoperative values, the intraocular pressure (IOP) of the third day after photocoagulation was elevated (0 933 ± 1 985) mmHg (1 mmHg = 0 133 kPa) (t = 2 82 1, P 0 01) , Temporal anterior chamber angle narrowed (t = 2033 ~ 3 15 0, P <0 05), anterior chamber slightly shallowed (t = 1 793, P 0 05). In 29 eyes (80 6%), ciliary body and anterior choroidal detachment occurred simultaneously, and simple ciliary body or anterior choroidal detachment occurred in 3 eyes. The upper quadrant ciliary body detachment height> other quadrants (F = 7 44, P = 0 0 0 0). One case of ciliary body and choroidal detachment continued until the 14th postoperative day, and the other patients with ciliary body and choroidal detachment subsided on the 7th day after operation. The height of ciliary body and choroidal detachment was significantly and positively correlated with age, but not with the duration of fasting blood glucose, diabetes and DR. Conclusion Retinal photocoagulation can cause early ocular hypertension in DR eye, anterior chamber angle narrowing, ciliary body and choroidal detachment anterior segment changes, age is one of the factors that affect the severity of ciliary body and choroidal detachment.