摘要
目的 探讨激光周边虹膜切除术联合激光前房角成形术治疗原发性闭角型青光眼的疗效及安全性。设计 回顾性、非对照病例研究。研究对象 原发性闭角型青光眼82例(112只眼)。方法 本组原发性闭角型青光眼病例,先行激光周边虹膜切除术,1周后行激光前房角成形术。主要指标 术前、术后观察眼压、视力、房角、视野、并发症。结果 随访6～18个月,平均11个月。激光治疗前眼压为(2 8 89±8 5 6 )mmHg ,治疗后为(19 98±7 37)mmHg(P <0 0 1)。93只眼(83 0 3% )眼压≤2 0 5 5mmHg ,其中2 4只眼需用抗青光眼药物,但点药次数较激光治疗前减少。19只眼(16 96 % )眼压未控制。视力提高32只眼(2 8 5 7% ) ,下降4只眼(3 5 7% ) ,不变76只眼(6 7 86 % )。10 4只眼(92 86 % )房角有不同程度增宽,8只眼(7 14 % )房角变化不明显。房角粘连范围减少90°以上或重新开放者6 6只眼(89 12 % ) ,不变者8只眼(10 81% )。激光治疗前后视野无明显变化。并发症:5只眼(4 4 6 % )瞳孔轻度扩大;13只眼(11 6 % )一过性眼压升高。结论 激光周边虹膜切除术联合前房角成形术治疗房角粘连范围小于3个象限的原发性闭角型青光眼创伤小,降眼压效果好,并发症较少。
Objective To investigate the efficacy and safety of laser peripheral iridectomy combined with laser gonioplasty for primary angle-closure glaucoma.Design Retrospective,noncomparative case series.Participants 82 patients (112 eyes) with primary angle-closure glaucoma (PACG).Methods Patients with PACG were treated with laser peripheral iridectomy and 1 week later followed by laser gonioplasty.Main Outcome Measures Intraocular pressure (IOP),visual acuity,anterior chamber angle and visual field were examined before and after laser surgery.Results The follow-up time was 6～18 months (mean 11 months).The mean IOP was (28.89±8.56) mmHg before the treatment,and (19.98±7.37) mmHg after the treatment (P<0.01).IOP of 93 eyes (83.03%) were 20.55mmHg or less,and of these,24 eyes took less anti-glaucoma drugs than that before the laser therapy.IOP of 19 eyes (16.96%) were not controlled.Visual acuity improved in 32 eyes (28.57%),decreased in 4 eyes (3.57%),and did not change in 76 eyes (67.86%).The anterior chamber angle became wider in 104 eyes (92.86%),and did not change obviously in 8 eyes (7.14%).The synechia range reduced more than 90° and reopened in 66 eyes (89.19%),and did not change in 8 eyes (10.81%).The visual field had no obvious change.Complications:Pupil enlarged slightly in 5 eyes (4.46%).IOP elevated transiently in 13 eyes (11.6%).Conclusions Laser peripheral iridectomy combined with gonioplasty is safe and effective in treating primary angle-closure glaucoma with synechia less than 270°.
出处
《眼科》
CAS
2005年第2期114-116,共3页
Ophthalmology in China
