摘要
目的观察前房穿刺联合Nd∶YAG激光周边虹膜切除治疗急性闭角型青光眼不同治疗时机的临床效果。方法回顾性分析急性闭角型青光眼首次急性发作患者64例64只眼,按急性发作后不同就诊时间分为三组：A组患者20例20只眼,就诊时间在24 h以内;B组患者23例23只眼,就诊时间24~72 h;C组患者21例21只眼,就诊时间72~120 h。在保守治疗眼压控制不佳的情况下行前房穿刺联合Nd∶YAG激光周边虹膜切除治疗,观察患者眼压、前房角开放及视力情况。随访时间6~18个月。结果治疗后A组17例（85.0%）、B组12例（52.2%）、C组4例（19.05%）在未用药或局部滴用1~2种降眼压药物后眼压可控制至目标眼压。治疗后有效率：A组优于B组（P〈0.05）;B组优于C组（P〈0.01）。其余31例31只眼接受了滤过手术。治疗后三组患者前房角开放〉180°者分别为：A组18例（90.0%）、B组13例（56.5%）、C组4例（19.1%）;A组优于B组（P〈0.05）,B组优于C组（P〈0.01）。三组患者术后眼压可控制,术后2 d最佳矫正视力分别为：A组优于B组（P〈0.05）,B组优于C组（P〈0.01）。结论急性闭角型青光眼急性发作早期（〈48 h）行前房穿刺联合Nd∶YAG激光周边虹膜切除可以有效控制眼压、开放房角,防止青光眼病变的继续发展,减少甚至避免行滤过性手术。
Objective To evaluate the effect of the combined therapy of anterior chamber paracentesis and Nd： YAG laser peripheral iridectomy on acute angle -closure glaucoma in different stages. Methods This research was a retrospective report. Altogether 64 （64 eyes） patients suffered acute angle-closure glaucoma for the first time were divided into three groups by the length of time from the attack to the diagnosis ： the 20 patients （20 eyes） in Group A were treated within 24hours after the attack ,23 patients （23 eyes） in Group B within 24-72 hours and 21 patients （21 eyes） in Group C within 72-120 hours. All the patients were given anterior chamber paracentesis and Nd ： YAG laser peripheral iridectomy once the in- trancular pressure （IOP） couldnt be controlled with drugs 48 hours after the diagnosis. The IOP, anterior chamber angle and visual a- cuity were observed. The follow-up of the patients lasted for 6-18months. Results The IOPs of 17 patients （17 eyes） in Group A, 12 patients （12 eyes） in Group B and 4 patients （4 eyes） in Group B were controlled with or without drugs. The result of Group A was better than that of Group B （ P 〉 0. 05 ） , and Group B better than Group C （P〈0.05）. Totally 31 patients（31 eyes）accepted filtering operation. 18 patients （18 eyes） in Group A, 13 patients （13 eyes） in Group B and 4 patients （4 eyes） in Group C had a change to the opening of anterior chamber angle greater than 180°. Group A was better than Group B （P 〈 0. 05 ）, and Group B better than Group C （P 〈 0. 05 ）. As to the best corrected visual acuity of the patients with controllable IOP 2 days after the treatment, Group A had a better performance than Group B （ P 〈 0. 05 ）, and Group B better than Group C （ P 〈 0. 05 ）. Conclusions At the early stage of acute attack of acute angle-closure glaucoma, the combination of anterior chamber paracentesis and Nd ： YAG laser peripheral iridectomy can control IOP effectively, prevent development of glaucoma and even avoid filtering operation.
出处
《中国激光医学杂志》
CAS
CSCD
2014年第6期315-318,共4页
Chinese Journal of Laser Medicine & Surgery
基金
国家自然科学基金资助项目(51073078)
关键词
激光
闭角型青光眼
前房穿刺
Laser
Angle-clouser Glaucoma
Paracentesis
