改良激光虹膜成形术治疗慢性闭角型青光眼  

Modified laser iridoplasty for chronic angle-closure glaucoma

作　　者：钱立峰[1] 张炬[1] 周欣欣[1] 王贝贝[1] 

机构地区：[1]郑州市第二人民医院眼科,河南省郑州市450000

出　　处：《眼科新进展》2010年第2期175-177,共3页Recent Advances in Ophthalmology

摘　　要：目的评估改良激光虹膜成形术治疗慢性闭角型青光眼的效果和安全性。方法应用氪激光大光斑自虹膜中外1/3交界处开始向前房角方向依次进行放射状光凝,范围为360°周边虹膜。用此方法治疗慢性闭角型青光眼患者31例52眼。观察术后1d、1周、1个月患者视力、眼压、角膜内皮细胞、前房角及术后并发症情况。结果改良激光虹膜成形术术前平均眼压为(42.7±8.9)mmHg(1kPa=7.5mmHg);术后1d、1周、1个月平均眼压分别为(15.3±8.2)mmHg、(14.4±11.1)mmHg、(14.8±13.2)mmHg,术后眼压与术前相比差异均有统计学意义(均为P<0.05)。术后1d、1周、1个月眼压≤21mmHg者分别为45眼(86.5%)、43眼(82.7%)、41眼(78.8%)。角膜内皮细胞平均密度术前为(2683±248)mm-2,术后1周为(2651±284)mm-2,术后1个月为(2625±321)mm-2,术后1周、1个月与术前相比差异均无统计学意义(均为P>0.05)。术后1d、1周、1个月前房角累积开放范围>1/2周者分别为46眼(88.5%)、44眼(84.6%)、42眼(80.8%)。术后所有患者均有不同程度的瞳孔变形(1周后减轻,1个月后有9眼未恢复)和虹膜炎症反应(用药3d后减轻或消失)。所有患者均无虹膜脱色素、出血、一过性眼压升高等并发症。结论改良激光虹膜成形术治疗慢性闭角型青光眼可使关闭的前房角开放,眼压得到控制,且无明显角膜内皮细胞的损害。Objective To investigate the efficacy and safety of modified laser iridoplasty for chronic angle-closure glaucoma.Methods Krypton laser light spots were used for radiated photocoagulation from 1/3 juncture of irial central-outside to angle of anterior chamber,ranging 360° periphery iris.A total of 31 cases（52 eyes） with chronic angle-closure glaucoma were treated with modified laser iridoplasty.Postoperative visual acuity,intraocular pressure（IOP）,corneal endothelial cells,angle of anterior chamber and postoperative complications were observed at postoperative 1 day,1 week,1 month.Results The mean IOP were（42.7±8.9）mmHg（1 kPa=7.5 mmHg）,（15.3±8.2）mmHg,（14.4±11.1）mmHg and （14.8±13.2）mmHg at preoperation,postoperative 1 day,1 week and 1 month,respectively.There was significant difference for postoperative IOP at different times compared with preoperative IOP（all P〈0.05）.IOP be and less than 21 mmHg were 45 eyes（86.5%） at postoperative 1 day,43 eyes（82.7%） at postoperative 1 week and 41 eyes（78.8%） at postoperative 1 month,respectively.The average densities of corneal endothelial cells were（2 683±248）mm^-2,（2 651±284）mm^-2 and （2 625±321）mm^-2 at preoperation,postoperative 1 week and 1 month.There was no significant difference for density of corneal endothelial cells at postoperative 1 week or 1 month compared with that preoperatively（both P〉0.05）.The accumulative opening of anterior chamber angle more than 1/2 cycle were 46 eyes（88.5%）,44 eyes（84.6%） and 42 eyes（80.8%） at postoperative 1 day,1 week and 1 month,respectively.Discoria at different degrees were found in all patients postoperatively,lightened at postoperative 1 week,and still uncovered in 9 eyes at postoperative 1 month or later.Iris inflammtory reaction was also found,and lightened or disappeared at 3 days after drug treatment.Iris depigmenting,hemorrhage and transient hight IOP were not found in all patients.Conclusion Modified laser iridoplasty can open the closed angl

关 键 词：激光虹膜成形术 慢性闭角型青光眼 眼压 

分 类 号：R775.2[医药卫生—眼科]