二极管激光经巩膜睫状体光凝术治疗急性闭角型青光眼持续性高眼压  

Diode laser transscleral cyclophotocoagulation in treatment of primary acute angle-closure glaucoma with durative intraocular hypertension

作　　者：李维娜 李学喜 

机构地区：[1]解放军180医院眼科,福建省泉州市362000

出　　处：《眼科新进展》2010年第6期577-579,共3页Recent Advances in Ophthalmology

摘　　要：目的评价二极管激光经巩膜睫状体光凝术治疗急性闭角型青光眼持续性高眼压的疗效。方法 40例(40眼)原发性急性闭角型青光眼急性大发作患者,经72h应用多种降眼压药物治疗后眼压仍在40mmHg(1kPa=7.5mmHg)以上,行二极管激光经巩膜睫状体光凝术。平均光凝能量(2290.00±149.01)mW,平均光凝点数(21.73±3.50)点。术后随访6～12个月,观察患者症状、眼压、视力变化和术后并发症等。结果术后随访期间全部患者眼痛症状均缓解。术前平均眼压为(52.56±7.31)mmHg,末次随访时平均眼压(14.18±4.53)mmHg,术后眼压与术前相比,差异有显著统计学意义(P<0.001)。术后平均视力(0.1270±0.1650)较术前(0.0334±0.0322)提高,差异也有显著统计学意义(P<0.01)。光凝术后25眼(62.5%)视力提高,8眼(20.0%)视力无变化,7眼(17.5%)视力下降。术后前房炎症反应伴前房渗出3例,前房出血1例,药物治疗后消失。结论二极管激光经巩膜睫状体光凝术治疗原发性急性闭角型青光眼持续性高眼压,疗效确切,可降低眼压,缓解疼痛,并发症少。Objective To evaluate the efficacy of diode laser transscleral cyclophotocoagulation（DLTC）in treatment of acute angle-closure glaucoma with durative intraocular hypertension.Methods The intraocular pressure （IOP） in 40 patients （40 eyes） with primary acute angle-closure glaucoma,one eye of which was in acute attack period,was still above 40 mmHg （1 kPa=7.5 mmHg） after being treated with several anti-glaucoma drugs for 72 hours,and all were treated with DLTC.Average laser energy was （2 290.00±149.01） mW and mean laser count was （21.73±3.50） points.The follow-up time was from 6 months to 12 months.The patients＇ symptom,IOP and changes of visual acuity were observed,the ocular fundus and slit lamp examination were performed.Results During the follow-up period,all patients＇ ocular pain were reduced.The mean IOP before DLTC and at the last follow-up time were （52.56±7.31）mmHg（1 kPa=7.5 mmHg）and （14.18±4.53） mmHg,respectively,the IOP decreased after DLTC,there was significant difference（P0.001）.The mean visual acuity before DLTC was 0.033 4±0.032 2,lower than 0.127 0±0.165 0 after DLTC,there was significant difference（P0.01）.After DLTC,the visual acuity improved in 25 eyes （62.5%）,had no change in 8 eyes （20.0%）,decreased in 7 eyes （17.5%）.After DLTC,the inflammation and exudation of anterior chamber appeared in 3 eyes,hyphema appeared in 1 eye,which were all cured after drug treatment.Conclusion DLTC in treatment of primary acute angle-closure glaucoma with durative intraocular hypertension has curative effect,can degrade the IOP,lessen ocular pain and with few complications.

关 键 词：二极管激光 睫状体光凝术 闭角型青光眼 

分 类 号：R779.6[医药卫生—眼科]