激光虹膜成形术治疗早期慢性闭角型青光眼观察  

Efficacy of treating the early-stage chronic angle closure glaucoma with laser peripheral iridoplasty

作　　者：刘修铎[1] 史春[1] 应坚[1] 徐惠娣 张玮[1] 

机构地区：[1]中国上海市杨浦区市东医院眼科,200438

出　　处：《国际眼科杂志》2015年第4期656-658,共3页International Eye Science

摘　　要：目的：观察Nd：YAG532激光虹膜周边成形术（Laser peripheral iridoplasty,LPIP）治疗早期慢性闭角型青光眼效果与安全性。方法：2011-09/2012-10内诊断为早期慢性闭角型青光眼患者36例65眼,行LPIP。术前术后观察眼压、前房角、视力、视野、眼底、并发症等情况。随访12~24（平均18.2±6.7）mo。结果：术前眼压23.8±5.6mmHg,LPIP术后1wk;术后1,3,6,12mo眼压分别为18.7±3.8,17.9±3.2,17.6±3.5,18.4±3.7,18.6±3.7mmHg,与术前比较差异全部具有统计学意义（P〈0.05）。最末次随访眼压为18.6±7.8mmHg,与术前比较平均下降6.5±3.1mmHg,差异具有统计学意义（t=5.32,P〈0.05）。术后1wk;术后1,3,6mo相比术前的前房角角度（TIA500）与500μm前房角开放距离（AOD500）增大有非常显著差异（P〈0.05）,术后1a与末次相比术前TIA500与AOD500无统计学意义（P〉0.05）。术后随访时间内视力无变化,杯盘比无增大,视野损害无进展。结论：激光虹膜周边成形术治疗早期慢性闭角型青光眼安全,短期内有效,中长期效果有回退,可以重复治疗。AIM： To evaluate the safety of the laser peripheral iridoplasty（ LPIP） for the early- stage chronic primary angle- closure glaucoma（ ECPACG）.METHODS： Sixty- five eyes of 36 patients with ECPACG received LPIP. At preoperative and postoperative,patients were examined with intraocular pressure（ IOP）,anterior chamber,optical coherence tomography（ OCT）,visual acuity,visual field,fundus and complications. The mean follow- up was 18. 2 ±6. 7mo（ ranged 12 ~24mo）.RESULTS： The preoperative average IOP were 23. 8 ±5. 6mmHg,postoperative 1wk,1,3,6,12 mo and in the last follow- up time the average IOP were 18. 7 ±3. 8,17. 9±3. 2,17. 6 ± 3. 5,18. 4 ± 3. 7,18. 6 ± 3. 7,and 18. 6 ± 7.8mmHg. There was statistical difference comparing with preoperative（ P 〈 0. 05, decreasing average 6. 5 ± 3.1mmHg compared with the preoperative,the difference was statistically significant（ t = 5. 32, P 〈 0. 05）.Postoperative 1wk,1,3,6mo,the trabecular- iris angle（ TIA500） and the angle opening distance at 500μm（ AOD500） had the statistical difference comparing with preoperative（ P 〈 0. 05）. At Postoperative 1a and the last follow- up time,the TIA500 and AOD500 did not have statistical difference comparing with preoperative（ P 〉 0.05）. The postoperative visual acuity,visual field,fundus had not changed. There were no complications found.CONCLUSION： LPIP is safe,and has the short time effect in the treatment of ECPACG. With elapse of time,the effect of LPIP is weakened. We can repeat the treatment.

关 键 词：激光 虹膜成形术 青光眼 成像 

分 类 号：R779.6[医药卫生—眼科]