激光瞳孔成形术与激光周边虹膜成形术治疗急性原发性前房角关闭的临床研究  

Comparisons of laser peripheral iridoplasty and laser pupilloplasty in the treatment of acute primary angle closure patients

作　　者：郭丽 杨一佺 郭黎霞[2] 吕爱国[2] 苗慧 韩伟[2] 胡建华 范肃洁 Guo Li;Yang Yiquan;Guo Lixia;Lyn Aiguo;Miao Hui;Han Wei;Hu Jianhua;Fan Sujie(Chengde Medical University,Chengde 067000,China;Ophthamology,Handan City Eye Hospital(The Third Hospital of Handan),Handan 056001,China;Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Institute of Ophthalmology,Beijing Key Laboratory of Ophthalmology and Visual Sciences,Beijing 100730,China)

机构地区：[1]承德医学院,067000 [2]邯郸市眼科医院(邯郸市第三医院)眼科,056001 [3]首都医科大学附属北京同仁医院,北京同仁医院眼科,北京市眼科研究所,眼科学与视觉科学北京市重点实验室,100730

出　　处：《中华眼科医学杂志（电子版）》2022年第1期12-17,共6页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

基　　金：河北省科技计划项目(16277790D)。

摘　　要：目的比较激光周边虹膜成形术(LPIP)和(或)激光瞳孔成形术(LPP)对急性原发性前房角关闭(APAC)的临床效果。方法回顾性分析2020年1月至2020年12月于邯郸市眼科医院(邯郸市第三医院)行LPIP和(或LPP)治疗的APAC患者81例(81只眼)。其中,男性15例(15只眼),女性66例(66只眼);年龄41~94岁,平均年龄(66.7±10.6)岁。按照激光治疗的方式分为联合组和LPIP组。联合组患者先后给予LPIP和LPP;LPIP组只行LPIP。以术后眼压≤30 mmHg(1 mmHg=0.133 kPa)为治疗初步有效。年龄和眼压经单样本Kolmogorov-Smirnov检验,符合正态分布,以x^(-)±s表示,组间比较采用独立样本t检验;视力、疾病发作持续时间及既往发作次数不符合正态分布,以中位数和四分位数表示,将Snellen视力换算成logMAR视力以便于统计学处理,组间比较采用Mann-Whitney U秩和检验。激光治疗的初步有效率和性别以例数和百分比表示,组间比较采用χ^(2)检验。两组患者术前、术后1 h及术后2 h视力和眼压的比较采用单因素方差分析。两组患者术前与术后2 h眼压变化幅度的影响因素采用广义线性回归模型分析。结果联合组患者42例(42只眼)。其中,男性6例(6只眼),女性36例(36只眼)。LPIP组患者39例(39只眼)。其中,男性9例(9只眼),女性30例(30只眼)。两组患者性别比较的差异无统计学意义(χ^(2)=1.04,P>0.05)。联合组和LPIP组患者术前眼压分别为(50.95±7.22)mmHg和(48.08±8.05)mmHg。两组患者术前眼压比较的差异无统计学意义(t=1.69,P>0.05)。两组患者术前logMAR视力分别为1.70(0.68,2.00)和1.70(0.90,2.00);发作持续时间分别为16.0(12.0,39.0)h和24.0(15.0,48.0)h;既往发作次数分别为0(0,3.5)次和0(0,1.0)次。经Mann-Whitney U秩和检验,术前两组患者视力、发作持续时间及既往发作次数比较的差异均无统计学意义(Z=-0.51,-0.99,-1.30;P>0.05)。联合组患者术后1 h和术后2 h的logMAR视力分别为0.50(0.20,0.80)和0.35Objective The aim of this study was to compare the clinic effect of laser peripheral iridoplasty(LPIP)and(or)laser pupilloplasty(LPP)on acute primary angle closure(APAC)patients.Methods 81 cases(81 eyes)of APAC patients treated with LPIP and(or)LPP from January 2020 to December 2020 were analyzed retrospectively.There were 15 males(15 eyes)and 66 females(66 eyes)with the average age of(66.7±10.6)years(ranged from 41 to 94 years-old).According to the method of laser treatment,they were divided into combined group and LPIP group.Patients in combined group were given LPIP and LPP successively;LPIP group only were treated by LPIP.The treatment with intraocular pressure(IOP)≤30 mmHg(1 mmHg=0.133 kPa)after laser treatment was defined as initial effective.The changes of IOP and visual acuity before and after laser treatment were compared.Age and IOP accorded with normal distribution by single sample Kolmogorov-Smirnov test,expressed as x±s,independent sample t-test was used for inter-group comparison.Visual acuity,duration of disease attack and number of previous attacks did not conform to the normal distribution,which were expressed in the median(quartile).Snellen visual acuity was represented as logMAR for statistical analysis.Mann-Whitney U rank sum test was used for comparison between groups.The initial effective rate and gender were expressed in the number and percentage,andχ^(2) test was used for comparison between groups.The visual acuity and IOP of two groups before and after laser treatment for 1 h and 2 h were compared by one-way ANOVA.The influencing factors of IOP before and after laser treatment for 2 h were analyzed by generalized linear regression model.Results In the combined group,there were 42 cases(42 eyes),6 males(6 eyes)and 36 females(36 eyes).In the LPIP group,there were 39 cases(39 eyes),9 males(9 eyes)and 30 females(30 eyes).There was not a significant difference in gender between two groups(χ^(2)=1.04,P>0.05).Preoperative IOP of patients in combined group and LPIP group were(50.95±7.22)mm

关 键 词：急性原发性前房角关闭 激光周边虹膜成形术 激光瞳孔成形术 

分 类 号：R779.6[医药卫生—眼科]