联合激光手术在急性闭角型青光眼发作期的早期应用  

Early Laser Surgery for Treatment of Acute Angle-closure Glaucoma

作　　者：杜宁静[1] 杨珂[1] 

机构地区：[1]广西壮族自治区人民医院眼科,南宁市530021

出　　处：《中国激光医学杂志》2009年第3期170-172,共3页Chinese Journal of Laser Medicine & Surgery

摘　　要：目的评价早期应用联合激光手术治疗急性闭角型青光眼发作期的安全性和有效性。方法对20例21只眼急性闭角型青光眼发作期患者采用532倍频激光,用低功率、大光斑和长时间与击射部位呈曲线形斜照,略模糊光斑聚焦光凝的周边虹膜成形术式,作用于虹膜根部光凝,产生收缩性的烧灼点,增强物理牵拉作用而使房角开放,同时行Nd∶YAG激光周边虹膜切除术治疗。结果21只眼行532倍频激光周边虹膜成形术后周边虹膜激光斑收缩,虹膜角膜间隙迅速加宽,使功能关闭的房角不同程度重新开放。联合Nd∶YAG激光周边虹膜切除术,解除瞳孔的阻滞,使房水引流功能恢复。20例21只眼术前平均眼压(mmHg)54.9,术后15 min降至39.36,30 min降至28.32,1 h降至20.14。治疗后眼压保持在≤21以下者有17只眼;另有4只眼眼压上限≥21 mmHg,用缩瞳药治疗后眼压控制在≤21 mmHg以下维持治疗。其中有4只眼需用抗青光眼药物维持治疗。5只眼术后一过性眼压升高。2只眼前房少许出血。虹膜透切率100.0%,无一例角膜内皮被击伤。结论早期应用联合激光手术是治疗急性闭角型青光眼发作期的一种安全有效的方法。Objective To investigate the safety and effectiveness of early laser treatment for acuteangle-closure glaucoma. Methods Twenty cases（21 eyes） with acute angle-closure glaucoma were treated by modified argon laser iridoplasty to widen full-circle of chamber angle,and then by Nd ：YAG laser peripheral iridectomy. Results The laser spots of 21 eyes were shrinked and fontana＇s spaces were widened quickly and chamber angles were reopened in different degree after argon iridoplasty and Nd ： YAG laser peripheral iridectomy. The mean intra-ocular pressure （IOP） was 54.9 mmHg before treatment and reduced to 39. 36 mmHg, 28. 32 mmHg and 20. 14 mmHg at 15 minutes,30 minutes and 1 hour, respectively after treatment. The penetration rate of iris was 100.0% and the corneal endothelium wasnt damaged. Conclusions Modified argon laser iridoplasty and Nd：YAG laser peripheral iridectomy are effective methods to reduce IOP early for treatment of acute angle-closure glaucoma.

关 键 词：闭角型青光眼 激光手术 早期治疗 

分 类 号：R779.63[医药卫生—眼科]