高眼压下行透明角膜切口虹膜周切术疗效分析  

Efficacy of immediate surgery peripheral iridectomy with a clear corneal incision in the control of acute primary angle closure

作　　者：何渊[1] 王华[1] 唐炘[1] 

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心北京市眼科学与视觉科学重点实验室,北京100730

出　　处：《中国实用眼科杂志》2011年第12期1245-1249,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的 了解高眼压状态下经透明角膜切口行虹膜周边切除术治疗原发性闭角型青光眼的疗效。方法前瞻性系列研究。对急性闭角型青光眼急性发作患者21例（21只眼），经全身及局部联合药物降眼压治疗眼压仍不能控制，行透明角膜切口虹膜周边切除术。术后观察患眼视力、眼压、房角，并发症等。结果21例急性闭角型青光眼急性发作期眼压（68．69±12．79）mmHg，经联合药物治疗后眼压（60．65±14．26）mmHg。经手术治疗后1d，3d，1周，1月，2月，6月眼压分别为（10．60±4．74）mmHg、（10．02±2．48）mmHg、（11．35±2．08）mmHg、（13．87±3．36）mmHg、（14．42±4．96）mmHg、（13．53±2．13）mmHg，各时间点较术前眼压差异具有统计学意义（P均〈0．001）。术后视力提高，18例患者房角开放，无特殊并发症。结论高眼压状态下经透明角膜切口行虹膜周边切除术治疗原发性闭角型青光眼，可以有效解除瞳孔阻滞，降低药物无法控制的高眼压，并完整保留了结膜组织。Objective To study the effectiveness of immediate surgery peripheral iridectomy （SPI） with a clear corneal incision in the treatment of acute primary angle-closure glaucoma. Methods Prospective case series. Twenty-one eyes of 21 consecutive patients with their first attack of acute pri- mary angle closure （APAC） were recruited into the study. The combination of topical and system medication treatment failed to lower the IOP of the patients. SPI was performed using a clear corneal incision perpendicular to the coronal plane, leaving the conjunctiva undisturbed to allow future Ttrabeculectomy if necessary. The corneal wound was self-sealing without suture. The outcomes of SPI in eyes with APAC were assessed in terms of final IOP, changes to visual acuity, anterior chamber angle and the incidence of complications. Results The mean IOP was reduced from （68.69± 12.79） mmHg to （60.65±14.26） mmHg after the combination of topical and system medication treatments. The lOP of 1 day, 3 days, 1 week, 1 month, 2 months and 6months after SPI treatment were （10.60± 4.74） mmHg, （10.02± 2.48） mmHg, （11.35±2.08） mmHg, （13.87± 3.36） mmHg, （14.42± 4.96） mmHg, （13.53 ±2.13） mmHg respectively, and the depression of IOP had the statistic significant （P 〈0.001）. No complications from the SPI were encountered. And the fellow eyes undertook Laser peripheral iridoto- my. Conclusions From this preliminary study, immediate SPI with a clear corneal incision seems to be effective and safe in controlling the intraocular pressure and eliminating symptoms in acute primary angle closure

关 键 词：虹膜周切术 透明角膜切口 急性闭角型青光眼急性发作 眼压 

分 类 号：R776.1[医药卫生—眼科]