原发性开角型青光眼复合小梁切除术后视盘主要参数的变化.docVIP

HRT-Ⅱ检测复合小梁切除术前后视盘参数变化(mRNFL) 手术前后比较差异有统计学意义（p 0.05），视盘上下象限mRNFL厚度手术前后比较差异有统计学意义（p 0.05）。结论 HRT-Ⅱ应用于POAG患者术后随访监测是一种客观的观察方法，具有高度可重复性、客观性。 [关键词 ]共焦激光眼底扫描仪；原发性；开角型青光眼； 视盘 The alteration of major parameters of optic disk after complex trabecu- lectomy in primary open angle glaucoma patients with HRT-Ⅱ HUANG Xu, Tang Yin, Xuan zhong-ning (Department of ophthalmology, Red Cross Hospital, Nanning 530012, Guangxi Zhuang Autonomous Region, China) [Abstract] Objective To evaluate the feasibility of application with HRT-Ⅱ to detect morphological alteration of optic disc in primary open angle glaucomatous patients after complex trabeculetomy. Methods 20 eyes of 20 cases with different stages of primary open angle glaucoma （POAG）were performed with complex trabeculectomy. All patient’s IOP were controlled without medicines. The following-up perior was 24 months. HRT-Ⅱscanning were differencely underwent in post-operation 3、6、12 and 24 months. Results There was significant difference (p0.05) between pre-operation and post oper- ation in cup/disk area ratio (C/D)、rim area (RA) 、mean and superior /inferior retinal nerve fibre layer (mRNFL) in all patients with different stages. Conclusion HRT-Ⅱ can be applied to detect the post-operative morphological alteration of optic disc in POAG patients with high objectivity and repeatability. [Key words] HRT-Ⅱ；primary；open angle glaucoma；optic disk 通讯作者：黄旭, 广西南宁市红十字会医院. Email：Happy xu-666@163.com 抗青光眼术后随诊复查，临床上常用的视功能检测方法主要有:视敏度、眼内压、直接检眼镜镜检查或前置镜裂隙灯眼底检查、视野检测、眼底彩色照相等。尤其是直接检眼镜检查，主观性比较强，不同检查者之间有较大误差；视野尽管仍作为青光眼患者术后评价金标准，但是其存在客观反映滞后性。因此，抗青光眼术后眼底视盘结构的变化如何客观记录及评价指标的确立，是眼科医生亟切解决的问题。我院自2005年9月至2008年9月三年间，采用HRT-Ⅱ对原发性开角型青光眼患者术后进行定期随访，获得比较满意评价效果，现将结果报告如下。 资料和方法 1.1一般资料：收集临床上确诊为原发性开角型青光眼、资料完整的患者20例20只眼归入本研究，高度近视眼排外。诊断原发性开角型青光眼标准：①Goldmann眼压计测≥21mmHg ②前房角镜检查开角③ Humphrey视野计模式偏差概率图支持，其中男性11例11只眼，女性9例9只眼，眼别无特别限制。年龄最小18岁，最大73岁，平均年龄47岁。病程1～8年，平均4年。视力从眼前指数～0.8，平均0.4，术前基础眼压23.5～45.8mmHg,平均32.4mmHg。角膜无水肿，晶状体混浊度LOCSⅡ分类0～Ⅱ级。眼底视杯/视盘比值(C