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目的观察巩膜环扎术后眼前节结构的变化，探讨术后继发性闭角型青光眼的发病机制。方法应用超声生物显微镜检查３０例（３３只眼）孔源性视网膜脱离患者术前、后３～７天的活体眼前节形态结构，并分别进行定量测定，检查结果经统计学分析，两组间配对ｔ检验，以Ｐ＜００５作为差异有显著性标准。结果术前ｌ只眼存在裂隙样睫状体脱离。术后１１只眼（３３３％）发生睫状体脱离，睫状体增厚水肿；术前睫状体厚度为（８２１３２±６４２１）μｍ，术后为（９４５２７±１０４１６）μｍ，差异有显著性（ｔ检验值２０３，Ｐ＜００５）。反映前房角改变的参数证实术后前房角变窄，房角开放距离５００减小，小梁虹膜夹角度数减小，巩膜外侧面虹膜长轴夹角度数减小，差异有显著性（ｔ检验值分别为１６９、１７８、１６６，Ｐ＜００５），而中央前房深度无明显变化，差异无显著性（ｔ检验值１３３，Ｐ＞００５）。结论巩膜环扎术后常可致睫状体脱离和睫状体水肿，术后前房角变窄，前房深度变化不明显。睫状体脱离和水肿可能与术后继发性闭角型青光眼有关。
Objective To observe the changes of anterior segment after scleral cerclage and to explore the pathogenesis of postoperative secondary angle-closure glaucoma. Methods Ultrasound biomicroscopy was performed on 30 cases (33 eyes) of rhegmatogenous retinal detachment before and 3 to 7 days after surgery. The morphological changes of the anterior segment of the eye were observed and quantified respectively. The results of the examination were statistically analyzed. Paired t test, with P <0 05 as a significant difference between the standard. Results There was fissured ciliary body detachment in one eye before operation. The ciliary body detached and the ciliary body thickened and edematous in 11 eyes (333%). The thickness of preoperative ciliary body was (82132 ± 6421) μm, and the postoperative was (94527 ± 104 16) μm, the difference was significant (t test value 2 03, P <0 05). Parameters reflecting the change of anterior chamber angle confirmed that the angle of the anterior chamber angle was narrowed, the angle of opening of the angle was reduced 500, the angle of the angle of trabeculae was decreased, and the angle of the long axis of the outer side of the sclera was decreased, the difference was significant t test values were 1 69,1 78,1 66, P 0 05), while the central anterior chamber depth had no significant change, the difference was not significant (t test value 1 33, P> 0 05 ). Conclusion Scleral cerclage often leads to ciliary body detachment and ciliary body edema, postoperative anterior chamber angle narrowing, anterior chamber depth changes was not obvious. Ciliary body detachment and edema may be related to postoperative secondary angle-closure glaucoma.