激光周边虹膜成形术联合周边虹膜切开术治疗原发性急性闭角型青光眼中期疗效观察  

Curative efficacy at intermediate term of laser peripheral iridoplasty combined with laser peripheral iridotomy in treatment of primary acute angle-closure glaucoma

作　　者：徐明[1] 陈海英[1] 黄正如[1] 王瑾瑜[1] 邢茜[1] 周卫文[1] 李函[1] 顾正[1] 

机构地区：[1]常熟市第二人民医院眼科,江苏省常熟市215500

出　　处：《眼科新进展》2011年第2期175-178,共4页Recent Advances in Ophthalmology

摘　　要：目的回顾性分析激光周边虹膜成形术（laser peripheral iridoplasty,LPIP）联合周边虹膜切开术（laser peripheral iridoto-my,LPID）治疗原发性急性闭角型青光眼急性发作的中期治疗效果。方法原发性急性闭角型青光眼急性发作患者51例（66眼）分为眼压控制组24例（32眼）、眼压未控制组11例（14眼）、门诊组16例（20眼）,分别行LPIP及LPID治疗。术后随访12~24个月,平均（15.36±2.61）个月。超声生物显微镜检查房角开放状况,观察控制眼压时间、术后眼压、并发症。结果眼压控制组治疗前后眼压比较,差异无统计学意义（P〉0.05）。眼压未控制组和门诊组的眼压在联合手术治疗后能迅速下降,2组术后0.5h、1h、2h的眼压分别为：（22.86±4.66）mmHg、（16.21±2.69）mmHg、（15.43±2.44）mmHg;（31.74±7.41）mm-Hg、（20.79±4.24）mmHg、（18.05±2.17）mmHg;与术前眼压比较,差异具有显著统计学意义（均为P〈0.001）。各组随访期间眼压均低于21mmHg（1kPa=7.5mmHg）。术后12个月,眼压未控制组、眼压控制组、门诊组平均眼压分别为（15.59±2.39）mmHg、（16.39±2.89）mmHg、（15.79±2.56）mmHg。超声生物显微镜检查示LPIP术后房角能迅速有效开放,随访期间无周边虹膜前粘连进展。LPIP和LPID治疗后无明显并发症。结论 LPIP能有效开放前房角,迅速降低眼压;联合LPID能安全有效治疗原发性急性闭角型青光眼的急性发作。Objective To explore curative efficacy at intermediate term of laser peripheral iridoplasty（LPIP）combined with laser peripheral iridotomy（LPID）in treatment of primary acute angle-closure glaucoma.Methods About 51 patients（66 eyes）with acute attack of primary acute angle-closure glaucoma were divided into IOP controlled group（24 cases,32 eyes）,IOP uncontrolled group（11 cases,14 eyes）and clinic group（16 cases,20 eyes）,and were performed LPIP and LPID.All cases were followed for 12 months to 24 months,averaged in（15.36±2.61）months.The status of anterior chamber angle was observed under ultrasound biomicroscopy.Control time of IOP,postoperative IOP and complications were observed.Results There was no statistical difference in IOP before and after treatment in IOP controlled group（P0.05）.IOP in IOP uncontrolled group and clinic group could quickly decrease after combined therapy,and there were significant difference compared with preoperative IOP at postoperative 0.5 hour,1 hour and 2 hours,which were（22.86±4.66）mmHg,（16.21±2.69）mmHg,（15.43±2.44）mmHg,（31.74±7.41）mmHg,（20.79±4.24）mmHg and（18.05±2.17）mmHg（all P0.001）.IOP was lower than 21 mmHg（1 kPa=7.5 mmHg）in each group at following up time.At postoperative 12 months,the average IOP were（15.59±2.39）mmHg,（16.39±2.89）mmHg and（15.79±2.56）mmHg in IOP uncontrolled group,IOP controlled group and clinic group.Ultrasound biomicroscopy showed anterior chamber angle could open immediately after LPIP.There was no periphery anterior synechia at following up time.There was no obvious complication after LPIP and LPID.Conclusions LPIP can open anterior chamber angle effectively and lower IOP quickly.LPIP combined with LPID can treat primary acute angle-closure glaucoma effectively and safely.

关 键 词：原发性急性闭角型青光眼 激光周边虹膜成形术 激光周边虹膜切开术 超声生物显微镜检查 

分 类 号：R779.6[医药卫生—眼科]