激光虹膜切除术治疗早期原发性闭角型青光眼  

A clinical observation of laser periphery iridotomy for early stage of primary angle-closure glaucoma

作　　者：张润琦[1] 李勇[1] 周永祚[1] 肖耀廷[1] 

机构地区：[1]上海市长宁区中心医院眼科,上海200336

出　　处：《眼外伤职业眼病杂志》2009年第7期509-511,共3页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的评价激光虹膜切除术治疗早期原发性闭角型青光眼的疗效。方法对62例(112眼)早期原发性闭角型青光眼按不同类型分为3组,分别行激光虹膜切除术,观察术前及术后1h、1周、3月的眼压、前房深度、前房角等变化情况。结果所有病例治疗后中央及周边前房深度都有不同程度加深。暗室试验阳性组治疗后平均眼压(13.71±2.29)mmHg,且房角未出现关闭。原发性急性闭角型青光眼组治疗后平均眼压(14.69±2.43)mmHg,11.9%的眼出现了15°以内的房角关闭。原发性慢性闭角型青光眼组治疗后平均眼压(23.18±5.66)mmHg,房角关闭增加15°以内5只眼,增加30°～60°的3眼,共占50.00%。结论激光虹膜切除术是预防和治疗早期闭角型青光眼,保护视功能的一种有效手段。但由于慢性闭角型青光眼发病机制复杂,应通过术前病例的合理选择及术后的密切随访,有效控制术后病情的发展。Objective To observe the efficiency of laser periphery iridotomy for early stage of primary angle-closure glaucoma.Methods Laser periphery iridotomy was performed on the fellow eyes of 62 cases （ 112 eyes） suffering from early stage of primary angle-closure glaucoma, which were divided into three groups according to the different type, intraocutar pressure （ IOP）, anterior chamber depth, anterior chamber angle were studied with pre-operation and post-operation by 1 hour,lweek,3months. Results In all cases, anterior chamber depth was increased; the IOP was successfully controlled within （ 13.71 ± 2.29 ） mmHg for the cases who shows positive result in 2-hours dark room test. In the team of acute angle-closure glaucoma, the lOP was under （ 14.69 ± 2.43 ） mmHg, 11.9% of the eyes shows angle closure within 15°. In the last team of chronic angle-closure glaucoma, the IOP was controlled within（23.18 ±5.66）mmHg, and five eyes were suffered angle closure under 15°, three eyes were between 30° -60°, totally 50% fails. Conclusion Laser periphery iridotomy is an effective method of preventing and treating early stage of primary angle-closure glaucoma;but due to the mechanism of chronic angle-closure glaucoma is so complicated , it is very important on case selection preoperation and observe closely post operation.

关 键 词：原发性闭角型青光眼 早期 激光周边虹膜切除 

分 类 号：R779.63[医药卫生—眼科]