急性闭角型青光眼激光周边虹膜成形术的疗效观察  

Observation on the efficacy of laser peripheral iridoplasty for acute primary angle-closure glaucoma

作　　者：韩波 胡义珍 朱晓梅 Han Bo;Hu Yizhen;Zhu Xiaomei(Department of Ophthalmology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院眼科,武汉430022

出　　处：《中华眼外伤职业眼病杂志》2020年第8期591-595,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：国家自然科学基金(81400378)。

摘　　要：目的:观察多波长激光周边虹膜成形术(LPIP)治疗原发性闭角型青光眼(PACG)急性发作的效果。方法:回顾性分析2017年9月至2019年4月华中科技大学同济医学院附属协和医院原发性闭角型青光眼急性期29例(31眼)的临床资料,患者入院后药物不能控制眼压、急诊行激光周边虹膜成形术。依据激光术后24小时前房角开放范围将患者分为两组。A组,4例(4眼),术后前房角开放范围≤180°;B组27例(27眼),术后前房角开放范围>180°。比较激光治疗术后两组症状、眼压及高眼压持续时间情况。结果:两组患者激光术后0.5小时、1小时以及3小时眼压均低于治疗前(P<0.05)。A组患者术前眼压以及高眼压持续时间均大于B组,差异均具有统计学意义(P<0.05)。结论:对于原发性闭角型青光眼急性发作期药物不能控制的患者,尽早施行激光周边虹膜成形术,安全有效。患者术前基础眼压较高及高眼压持续时间较长均影响治疗的效果。Objective To observe the efficacy of laser peripheral iridoplasty(LPIP)in the treatment of with acute stage of primary angle-closure glaucoma(PACG).Methods The clinical data of 31 eyes of 29 cases with acute primary angle-closure glaucoma from Sep.2017 to Apr.2019 in Union Hospital,Tongji Medical College,Huazhong University of Science and Technology were analyzed retrospectively.All cases uncontrolled IOP with drug received emergency LPIP.The patients were divided into two groups based on the open range of the anterior chamber angle at 24 hours after surgery.The open range of the anterior chamber was≤180°in group A,while in group B that was>180°after surgery.The symptom,changes of intraocular pressure and duration of high intraocular pressure were observed before and after treatment.Results The intraocular pressure at 0.5,1 and 3 hours after LPIP in the two groups was lower than that before treatment(P<0.05).The preoperative intraocular pressure and duration of high intraocular pressure of group A were higher than those of group B.And the difference was statistically significant(P<0.05).Conclusion LPIP is safe and effective for patients with the acute attack phase of primary angle-closure glaucoma which could not be controlled with drugs.The duration of preoperative high intraocular pressure(IOP)and preoperative basal IOP will affect the efficacy of laser peripheral iridoplasty.

关 键 词：青光眼 闭角型 急性 原发性 虹膜成形术 周边 激光 眼压 角 前房 

分 类 号：R779.6[医药卫生—眼科]