Nd∶YAG激光周边虹膜切开术治疗药物难控制性PACG发作期的疗效  

Observation on the efficacy of Nd∶YAG laser peripheral iridotomy in the treatment of drug-uncontrollable PACG in acute attack

作　　者：王羽西 潘颖喆 邓玲 冯焕焕 Yu-Xi Wang;Ying-Zhe Pan;Ling Deng;Huan-Huan Feng(Postgraduate Training Basement of Jinzhou Medicical University, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, Hubei Province, China;Department of Ophthalmology, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, Hubei Province, China)

机构地区：[1]锦州医科大学湖北医药学院附属襄阳市第一人民医院培养基地,中国湖北省襄阳市441000 [2]湖北医药学院附属襄阳市第一人民医院眼科,中国湖北省襄阳市441000

出　　处：《国际眼科杂志》2021年第2期351-354,共4页International Eye Science

摘　　要：目的:观察Nd∶YAG激光周边虹膜切开术(LPI)治疗药物难控制性原发性闭角型青光眼(PACG)急性发作期患者的疗效。方法:采用前瞻性研究,纳入襄阳市第一人民医院眼科2019-05/2020-06收治的药物难控制性PACG急性发作期患者20例22眼,所有受试对象均行LPI治疗,术前和术后检查患者视力、眼压、房角关闭范围、前房角角度(ACA)、前房容积(ACV)、中央前房深度(CACD)、周边前房深度(PACD)以及并发症。结果:受试对象均可实施LPI。术前房角关闭范围均>180°,术后房角关闭范围≤180°有9眼(41%);21眼(95%)术后眼压与术前相比明显降低(P<0.05);术后前房参数除CACD无明显变化(P>0.05),ACA、ACV、PACD均较术前增加(P<0.05)。术中15眼(68%)发生虹膜小瀑布样或丝样出血,5眼(23%)出现角膜上皮层损伤。结论:LPI在药物难控制性PACG急性发作期可以实施,安全性高,能有效降低眼压,缓解症状,疗效显著。AIM:To explore the effects of Nd∶YAG laser peripheral iridotomy(LPI)in the treatment of drug-uncontrollable primary angle-closure glaucoma(PACG)in acute attack.METHODS:A prospective study was conducted on 22 eyes of 20 patients with drug-refractory primary angle-closure glaucoma treated in the Department of Ophthalmology of Xiangyang No.1 People’s Hospital from May 2019 to June 2020.All subjects underwent Nd∶YAG LPI.Visual acuity,intraocular pressure,chamber angle closure range,anterior chamber angle(ACA),anterior chamber volume(ACV),central anterior chamber depth(CACD)and peripheral anterior chamber depth(PACD)were measured before and after the operation.And observe the complications of LPI.RESULTS:All patients can implement LPI.All subjects’chamber angle closure range were>180°before LPI and 9 eyes(41%)were≤180°after LPI.The intraocular pressure of 21 eyes(95%)had significantly lower than postoperative(P<0.05).Postoperative anterior chamber parameters such as ACA,ACV and PACD were increased(P<0.05).During the operation,15 eyes(68%)had iris cascade or silk hemorrhage and 5 eyes(23%)had corneal epithelial damage.CONCLUSION:LPI has high safety and can be implemented in the acute attack stage of drug-uncontrollable PACG.It can reduce intraocular pressure effectively and relieve symptoms,which has a significant effect in the patients.

关 键 词：原发性闭角型青光眼 急性发作期 激光周边虹膜切开术 

分 类 号：R779.6[医药卫生—眼科]