原发性前房角关闭眼激光周边虹膜成形术疗效分析  

The emcacy of laser peripheral iridoplasty to primary angle closure after laser peripheral iridectomy

作　　者：叶雷[1] 田祥[1] 张英[1] 潘乐[1] 罗鑫[1] 

机构地区：[1]遵义医学院附属医院眼科,遵义563003

出　　处：《中国实用眼科杂志》2013年第4期417-420,共4页Chinese Journal of Practical Ophthalmology

基　　金：贵州省科学技术基金项目（黔科合J字[2010]2183号）

摘　　要：目的观察原发性前房角关闭眼（PAC）行激光周边虹膜切除术（LPI）及激光周边虹膜成形术（ALPI）治疗效果。方法应用前瞻性干预性系列病例研究。对2009年12月至2011年12月在遵义医学院附属医院眼科对18只眼LPI治疗后的PAC，再进行ALPI治疗，两周后在暗光下行UMB检查。观察指标：ACD、AOD、TIA、IT1、TCPD、ILA、ILCD。激光周边虹膜成形术前后用对照配对t检验，P〈0．05差异有统计学意义。结果18只眼行ALPI后房角关闭率为16．7％（3／18）。ALPI术前、术后ACD、ILA、ILCD相比差异无统计学意义（P〉0．05）；术后AOD500、TIA均比ALPI术前增大（P〈0．05），房角增宽；术后TCPD比ALPI术前增大（P〈0．05），睫状体后移；术后IT1较ALPI术前变薄（P〈0．05）。结论对LPI后仍存在暂时性房角关闭的PAC眼，ALPI能使房角增宽及周边虹膜厚度变薄，可能阻止部分PAC变为PACG，降低PACG的发生率。Objective To evaluate the UBM change of after and before laser peripheral iridoplas- ty （ALPI） for primary angle closure eyes, which angle still closed after laser peripheral iridectomy （LPI）, and to explore the therapy of primary angle closure （PAC）. Methods Prospective interven- tion observational case series. ALPI was given to 18 eyes which were observed primary angle clo- sure after LPI through UBM. Two weeks later, UBM was used once again in the dark lighting con- ditions. The observation parameters two times including anterior chamber distance （ACD）, angle open distance （AODS00）, trabecular iris angle （TIA）, iris thickness （IT1）, trabecular ciliary process distance （TCPD）, iris lens angle （ILA）, iris lens contact distance （ILCD）. The t test was employed to compare means of quantitative variables. For all tests, a level of statistical significance P 〈0.05 was adopted. Results Three of 18 eyes with PAC were observed angle closed after ALPI （16.7%）. The change of ACD, ILA and ILCD in postoperative showed no significant statistical significance compared to preoperative （P 〉0.05）. The AOD500, TIA and TCPD increased and IT1 decreased after ALPI （P 〈0.05）. Conclusions ALPI can widen the peripheral anterior angle and thin the IT1 of pri- mary angle closure eyes, whose angle still closed after LP1. So that, ALPI may be a efficient meth- od to prevent PAC deteriorating to PACG.

关 键 词：原发性前房角关闭 激光周边虹膜成形术 活体超声生物显微镜 

分 类 号：R775.2[医药卫生—眼科]