激光虹膜成形术联合Nd:YAG激光治疗闭角型青光眼的效果和安全性分析  

Effect and Safety Analysis on Joint Treatment of Angle-Closure Glaucoma with Laser Iridoplasty and Nd:YAG Laser

作　　者：马远程 李磊[1] 王孟文 康婧 MA Yuancheng;LI Lei;WANG Mengwen;KANG Jing(Department of Ophthalmology,Bazhong Central Hospital,Bazhong 636000,China;Department of Cardiology,Bazhong Central Hospital)

机构地区：[1]巴中市中心医院眼科,巴中市636000 [2]巴中市中心医院心内科,巴中市636000

出　　处：《中国激光医学杂志》2023年第4期208-213,240,共7页Chinese Journal of Laser Medicine & Surgery

摘　　要：目的探讨激光虹膜成形术联合Nd∶YAG激光治疗闭角型青光眼的效果和安全性。方法选取2019年2月至2021年2月,闭角型青光眼患者54例,按随机数字表法分为观察组和对照组,每组患者各27例27只眼。观察组使用激光虹膜成形术联合激光虹膜切开术进行治疗,光斑直径500μm,曝光时间400 ms,连续输出,治疗功率140~300 mW,再行Nd∶YAG激光虹膜切开术,治疗光参数为能量4~7 mJ、脉冲频率3~4 Hz;对照组使用传统小梁切除术治疗。记录术前、术后1个月、术后3个月、术后12个月两组患者的角膜内皮细胞密度(corneal endothelial cell density,ECD)、房角开放距离(angle open distance 500,AOD500)、眼压(intraocular pressure,IOP)、中央前房深度(anterior chamber depth,ACD)等变化,比较两组患者治疗后12个月内并发症的发生率。结果术后1个月、术后3个月、术后12个月,两组患者IOP水平均低于术前(P<0.05),且观察组明显低于对照组(P<0.05)。术后1个月,观察组AOD500水平急剧升高,术后3个月、术后12个月时,缓慢下降。术后1个月、术后3个月、术后12个月,两组患者AOD500水平均高于术前,观察组AOD500水平均高于对照组(P<0.05)。术后1个月、术后3个月、术后12个月,观察组患者ACD水平逐步下降,观察组ACD水平均高于术前(P<0.05),与对照组比较差异具有统计学意义(P<0.05)。观察组患者术后1个月、术后3个月、术后12个月时ECD水平高于对照组(P<0.05)。研究组并发症总发生率低于对照组,差异具有统计学意义(P<0.05)。结论激光虹膜成形术联合Nd∶YAG激光治疗闭角型青光眼治疗效果好,安全性高,利于患者术后眼功能的恢复。Objective To investigate the efficacy and safety to treat angle-closure glaucoma jointly with laser iridoplasty and Nd∶YAG laser.Methods Totally 54 patients with angle-closure glaucoma treated over the period from Feb.2019 to Feb.2021 were selected and divided randomly into two groups:the observation group(n=27) and control group(n=27).The patients(27 eyes) in the observation group were treated jointly with laser iridoplasty and Nd∶YAG laser iridotomy,and those(27 eyes) in the control group were given traditional trabeculectomy.The 1,3 and 12 months postoperative corneal endothelial cell density(ECD),angle open distance(AOD),intraocular pressure(IOP) and anterior chamber depth(ACD) were observed and compared between two groups.The incidences of complications within 12 months in both groups were also analyzed.Results The IOP levels 1,3 and 12 months after the surgery were lower than those before the surgery in both groups,and those in the observation group were significantly lower than those in the control group(P<0.05).In the observation group,the level of AOD500 increased sharply after the operation,and decreased slowly 3 and 12 months after the operation.For both groups,the levels of AOD500 1,3 and 12 months after the operation were higher than those before the operation,and the levels were higher in the observation group than in the control group(P<0.05).The level of ACD decreased gradually 1,3 and 12 months after operation in the observation group.The levels of ACD in the observation group 1,3 and 12 months after the operation were higher than that before the operation,and the ACD level was higher in the observation group than in the control group at each time point(P<0.05).The ECD level in the observation group was higher than that in the control group 1,3 and 12 months after the operation(P<0.05).The overall incidence of complications was less in the study group than in the control group,and the difference was statistically significant(P<0.05).Conclusions As to the treatment of angle-closure glaucoma,th

关 键 词：激光 激光虹膜成形术 闭角型青光眼 疗效 安全性 

分 类 号：R616.4[医药卫生—外科学] R773.1[医药卫生—临床医学]