Khảo sát phần trước nhãn cầu bằng máy AS - OCT trên mắt Glôcôm góc mở nguyên phát sau phẫu thuật cắt bè

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Tác giả: Kim Thành Đoàn, Ngọc Thanh Ngân Nguyễn, Thảo Hương Nguyễn, Anh Tuấn Trần

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y Dược học Phạm Ngọc Thạch, 2024

Mô tả vật lý: tr.97

Bộ sưu tập: Metadata

ID: 341833

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Đặt vấn đề: Phẫu thuật cắt bè củng mạc (CBCM) từ lâu đã được chứng minh là một biện pháp an toàn và phổ biến để giảm nhãn áp dài hạn, một trong những lựa chọn tối ưu điều trị glôcôm góc mở nguyên phát (GGMNP). Đã có nhiều báo cáo về việc phẫu thuật cắt bè làm giảm độ sâu tiền phòng và tác động đáng kể lên phần trước. AS - OCT là phương pháp khách quan, không xâm lấn và cho kết quả có độ chính xác cao với hình ảnh chi tiết về sự thay đổi của các cấu trúc này. Mục tiêu nghiên cứu: Đánh giá sự thay đổi về hình thái của phần trước nhãn cầu bằng máy AS - OCT sau phẫu thuật cắt bè củng mạc. Đối tượng và phương pháp nghiên cứu: Nghiên cứu quan sát mô tả cắt dọc hàng loạt ca, 24 bệnh nhân với 37 mắt GGMNP được đưa vào nghiên cứu. Bệnh nhân được đánh giá lâm sàng và khảo sát biến số trên AS - OCT bao gồm chiều dày giác mạc (CDGM), độ sâu tiền phòng (ĐSTP), diện tích tiền phòng (DTTP), chiều rộng tiền phòng (CRTP) sau phẫu thuật cắt bè trên bệnh nhân glôcôm góc mở nguyên phát tại các thời điểm 1 tuần, 1 tháng. Kết quả: Nhãn áp (NA) trước mổ là 29,9 ± 14,6 mmHg, sau mổ 1 tháng giảm mất 13,2 ± 9,1 mmHg (p <
0,001). CDGM trước mổ là 536,3 ± 20,1 mm sau phẫu thuật 1 tháng giảm mất 8,8 ± 5,3 mm (p <
0,001). ĐSTP trước mổ là 2,9 ± 0,2 mm, sau phẫu thuật 1 tháng giảm mất 0,3 ± 0,2 mm (p <
0,001). CRTP trước mổ là 11,7 ± 0,4 mm sau 1 tháng giảm mất 0,1 ± 0,05 mm (p <
0,001). DTTP trước mổ là 23,9 ± 4,9mm, sau phẫu thuật 1 tháng tăng thêm 1,7 ± 1,0 mm2. Chênh lệch NA trước và sau điều trị có tương quan với sự thay đổi của CDGM (r = 0,3) , ĐSTP (r = 0,01), DTTP (r = 0,06). Kết luận: Có sự thay đổi hình thái phần trước nhãn cầu sau phẫu thuật cắt bè. AS - OCT có thể sử dụng như một công cụ theo dõi hiệu quả điều trị mang tính khách quan. Abstract Background: Trabeculectomy has shown as a safe and common method for long - term reduction of intraocular pressure, one of the optimal treatment options for primary open angle glaucoma. (POAG). Previous studies have found the reducing of anterior chamber depth and significant changes in anterior segment after surgery. AS - OCT is an objective, non - invasive and highly accurate method with detailed images of these structural changes. Objective: To evaluate the morphological changes of the anterior segment in eyes with POAG by AS - OCT after trabeculectomy. Materials and method: A cross - sectional descriptive observational study of cases series, 24 patients with 37 POAG eyes were included in the study. Patients were clinically evaluated and surveyed variables on AS - OCT including central corneal thickness (CCT), anterior chamber depth (ACD), anterior chamber area (ACA), anterior chamber width (ACW) on primary open glaucoma at 1 week, 1 month post - trabeculectomy. Results: Preoperative intraocular pressure (IOP) was 29.9 ± 14.6 mmHg, 1 month after surgery it lost 13.2 ± 9.1 mmHg (p <
0.001). Preoperative CCT was 536.3 ± 20.1 mm after surgery 1 month, it lost 8.8 ± 5.3 mm (p <
0.001). Preoperative ACD was 2.9 ± 0.2 mm, 1 month after surgery, the loss was 0.3 ± 0.2 mm (p <
0.001). The preoperative ACW was 11.7 ± 0.4 mm after 1 month, the loss was 0.1 ± 0.05 mm (p <
0.001). ACA before surgery was 23.9 ± 4.9mm, 1 month after surgery increased by 1.7 ± 1.0 mm2. The difference in NA before and after treatment was correlated with the change of CCT (r = 0.3), ACD (r = 0.01), ACA (r = 0.06). Conclusion: There is a change in the morphology of the anterior segment in eyes with POAG after trabeculectomy. AS - OCT might be of great value for following up PDR patients after trabeculectomy. DOI: 10.59715/pntjmp.2.3.11

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