激光周边虹膜切开术治疗原发性慢性闭角型青光眼不同程度前房角粘连的疗效观察  

Laser peripheral iridectomy in the treatment of chronic angle-closure glaucoma with various degrees of chamber angle synechia

作　　者：范肃洁[1] 崔宏宇[1] 郭黎霞[1] 韩伟[1] 张志宏[1] 李继英[1] 吕靖[1] 张军明[1] 曹志刚[2] 

机构地区：[1]河北省邯郸市眼科医院,056001 [2]河北省邯郸市第一医院眼科

出　　处：《中华眼科医学杂志（电子版）》2012年第3期147-149,共3页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

摘　　要：目的观察激光周边虹膜切开术治疗不同前房角粘连状态的原发性慢性闭角型青光眼(CACG)患者的疗效。方法回顾性系列病例研究。将2005年1月至2006年12月就诊于河北省邯郸市眼科医院的原发性慢性闭角型青光眼患者70例(137只眼),按前房角粘连范围分成2组:A组为前房角粘连关闭<180°(95只眼),B组为前房角粘连关闭≥180°(42只眼)。全部患者行激光周边虹膜切开术治疗,治疗后随访18个月,观察患者眼压、用药及手术并发症情况。对两组眼压数据采用t检验的方法进行比较分析。以P<0.05为差异有统计学意义。结果 A组治疗前平均眼压为(22.05±9.91)mm Hg,(1 mm Hg=0.133 kPa)治疗后18个月平均眼压为(18.62±3.96)mm Hg,其中未用药眼压≤21 mm Hg者80只眼,占84.21%(80/95),转行滤过性手术者4例(4只眼),占4.21%(4/95)。B组治疗前平均眼压为(39.05±16.34)mm Hg,治疗后18个月平均眼压为(27.71±9.84)mm Hg,用药后眼压≤21 mm Hg者12只眼,占28.57%(12/42),转行滤过性手术者8例(8只眼),占19.05%(8/42)。结论激光周边虹膜切开术对于前房角粘连关闭<180°的早期CACG有效;对于前房角粘连关闭≥180°的CACG患者具有一定的疗效,但应密切随诊,如眼压不能控制,应及时选择滤过性手术。Objective To evaluate the curative effect of laser peripheral iridectomy in the treatment of chronic angle-closure glaucoma with various degrees of chamber angle synechia. Methods It was a retrospective case series study. 137 eyes in 70 cases with chronic angle closure glaucoma from 2005 to 2006 in Handan eye hospital were randomly divided into group A and group B. Group A included 95 eyes whose chamber angle synechia is less than 180° and group B included 42 eyes whose chamber angle synechia is equal or to more than 180°. All of them were treated by laser peripheral iridectomy and followed by 18 months to observe the intraocular pressure,medications and complications. Results In group A,the average intraoculaer pressure was( 22. 05 ± 9. 91) mm Hg( 1 mm Hg = 0. 133 kPa) before operation and( 18. 62 ± 3. 96) mm Hg18 months after operation during which 80 eyes( 84. 21%) kept a normal intraoculaer pressure without any medication while 4 cases( 4. 21%) turned to trabeculectomy. In group B,the average intraoculaer pressure was( 39.05 ±16.34) mm Hg before operation and( 27. 71 ± 9. 84) mm Hg 18 months after operation. 12 eyes( 28. 57%) kept a normal intraoculaer pressure under medication while 8 cases( 19. 05%) turned to trabeculectomy. Conclusions Laser peripheral iridectomy is an effective way in treating chronic angle-closure glaucoma with chamber angle synechia less than 180°,but for those whose chamber angle synechia is equal to or more than 180°,a close follow-up is important in order to evaluate whether trabeculectomy is necessary.

关 键 词：慢性闭角型青光眼 激光疗法 虹膜周边切开术 

分 类 号：R779.63[医药卫生—眼科]