激光周边虹膜切除术联合成形术治疗原发性闭角型青光眼的远期疗效观察  

ELong-term outcomes of laser peripheral iridectomy combined with laser peripheral iridoplasty for primary angle closure glaucoma

作　　者：吴琳艳[1] 王凯[1] 范茂利 WU Lin-yan;WANG Kai;FAN Mao-li(Department of Ophthalmology,The Fifth People's Hospital of Fuyang,Fuyang Anhui 236000,China)

机构地区：[1]阜阳市第五人民医院眼科,安徽阜阳236000

出　　处：《实用防盲技术》2020年第2期79-81,共3页Journal of Practical Preventing Blind

摘　　要：目的观察激光虹膜切除术(LPI)联合激光周边虹膜成形术(LI)治疗原发性闭角型青光眼(PACG)的远期疗效。方法收集2014年1月至2016年12月在阜阳市第五人民医院确诊的PACG患者65例67眼,包括急性闭角型青光眼临床前期,缓解期48眼和慢性闭角型青光眼早期19眼,均接受LPI联合LI术,随访观察3年比较术前术后眼压,前房角形态及前房深度。结果67眼术后3年眼压平均值为20.47+2.94mmHg,与术前眼压平均值24.44+3.25mmHg相比,眼压下降有统计学意义。其中未加降眼压药物眼压即可控制在21mmHg以下的有39眼,21眼需一种抗青光眼药物即可将眼压控制在21mmHg以下,有4眼需使用两种或两种以上抗青光眼药物才能将眼压控制在21mmHg以下,有3眼使用抗青光眼药物不能控制眼压且出现青光眼视神经损伤及视野缺损,行外滤过手术。67眼术前平均前房深度为1.688+0.215mm,术后平均前房深度1.762+0.274mm,平均前房深度加深有统计学意义,其中56眼前房深度较术前增加,5眼前房深度无明显变化,6眼前房深度变浅。结论LPI联合LI可长期有效控制大多数PACG眼的眼压,增加其前房深度,部分患者术后的眼压控制及前房深度不如预期的好。Objective To study the long-term efficacy of laser peripheral iridectomy(LPI) combined with laser peripheral iridoplasty(LI)for primary angle closure glaucoma(PACG).Methods Sixty-five cases of PACG patients(67 eyes) diagnosed in the Fifth People’ Hospital of Fu Yang from January 2014 to December 2016.There were 48 cases of preclinical stage and remission stage of acute PACG and 19 cases of early chronic PACG.LPI combined with LI were performed on the eyes.Patients who were followed-up for at least3 years.The parameters observed and compared included intraocular pressure(IOP),anterior chamber depth(ACD),angle forms before and after operation.Results The average IOP of sixty seven cases of eyes decreased from 24.44+3.25 mmHg pre-surgery to20.47+2.94 mmHg three years after surgery.There were statistically significant of IOP decrease.Among them there were 39 cases can control IOP below 22 mmHg that did not add(without adding) anti-glaucomatous drugs.For 21 cases,one kind of anti-glaucomatous drugs was required to keep the IOP below 22 mmHg(in 21 cases).Four cases needed two or more anti-glaucomatous drugs to keep the IOP below 22 mmHg.There were three cases had external filtration surgery that could not control the IOP with anti-glaucomatous drugs and glaucoma optic nerve injury and visual field defect were found.The average ACD of sixty seven cases of eyes creased from1.688+0.215 mm pre-surgery to 1.762+0.274 mm post-surgery.The average ACD was statistically significant.The ACD of fifty six of them increased compared with that before the operation,five cases did not change significantly,six cases become shallow.Conclusions LPI combined with LI can effectively control most IOP of PACG eyes and increase its ACD over a long period of time.However,the IOP and ACD of some patients were not as good as expected.

关 键 词：闭角型青光眼 激光 周边虹膜切除术 周边虹膜成形术 

分 类 号：R779.6[医药卫生—眼科]