原发房角关闭患者白内障术后房角增宽及睫状突结构改变

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Purpose: To evaluate quantitatively, by means of ultrasound biomicroscopy (UBM), changes in the anterior segment con-figuration, including the ciliary processes, induced by cataract surgery in eyes with primary angle closure. Design: Retrospective interventional case series. Participants: Thirty-one eyes of 31 patients with primary angle closure or primary angle-closure glaucoma were treated with cataract surgery. Before cataract surgery, 10 eyes had been treated with laser peripheral iridotomy, and 1 with laser peripheral iridoplasty. Methods: Configuration of the anterior chamber was examined by means of UBM before and at 3 months after cataract surgery. Main Outcome Measures: Using UBM, anterior chamber depth (ACD), angle opening distance at points 500 μ m from the scleral spur (AOD500), and trabecular-ciliary process distance (TCPD) were measured. Results: Not only ACD and AOD500, but also TCPD, increased significantly after cataract surgery, compared with measurements obtained before surgery (P < 0.001). Postoperative AOD500 was correlated significantly with postoperative TCPD (r=0.72, P < 0.001) and with the amount of change of TCPD caused by cataract surgery (▲ TCPD)(r=0.52, P < 0.01). Conclusions: Cataract surgery attenuated anterior positioning of the ciliary processes in eyes with primary angle closure,concomitant with significant widening of the angle. Cataract surgery resulted in not only complete dissolution of lens volume and pupillary block, but also attenuation of the anterior positioning of the ciliary processes, all of which contributed to postoperative widening of the anglein eyes with primary angle closure. Purpose: To evaluate quantitatively, by means of ultrasound biomicroscopy (UBM), changes in the anterior segment con-figuration, including the ciliary processes, induced by cataract surgery in eyes with primary angle closure. Design: Retrospective interventional case series. Participants: Thirty -one eyes of 31 patients with primary angle closure or primary angle-closure glaucoma were treated with cataract surgery. Before cataract surgery, 10 eyes had been treated with laser peripheral iridotomy, and 1 with laser peripheral iridoplasty. Methods: Configuration of the anterior chamber was taken by UBM before and at 3 months after cataract surgery. Main Outcome Measures: Using UBM, anterior chamber depth (ACD), angle opening distance at points 500 μm from the scleral spur (AOD500), and trabecular-ciliary process Results: Not only ACD and AOD500, but also TCPD, increased significantly after cataract surgery, compared with measurements obtained be postoperative AOD500 was correlated significantly with postoperative TCPD (r = 0.72, P <0.001) and with the amount of change of TCPD caused by cataract surgery (▲ TCPD) (r = 0.52, P <0.01) . Conclusions: Cataract surgery attenuated anterior positioning of the ciliary processes in eyes with primary angle closure, concomitant with significant widening of the angle. Cataract surgery resulted in not only complete dissolution of lens volume and pupillary block, but also attenuation of the anterior positioning of the ciliary processes, all of which contributed contributed post postoperative widening of the anglein eyes with primary angle closure.
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