激光虹膜成形联合虹膜根切术治疗急性闭角型青光眼

Laser Peripheral Iridoplasty Combined with Iridotomy for Acute Angle-closure Alaucoma

目的观察激光周边虹膜成形联合虹膜根切术治疗急性闭角型青光眼的疗效。方法原发性急性闭角型青光眼第一次发作时予以药物降低眼压,待角膜透明、瞳孔回缩后,26例(26只眼)行激光周边虹膜成形术,在虹膜周边360°范围击射30点,于鼻下方或颞下方击射周边虹膜范围约1 mm,用掺钕钇铝石榴石(Nd:YAG)激光击穿虹膜。结果激光后2 h,26例26只眼的眼压≤21 mmHg(1 mmHg=0.133 kPa),房角由术前关闭到术后不同程度开放,虹膜周切孔通畅。结论激光周边虹膜成形联合激光虹膜根切术能有效加宽房角,解除瞳孔阻滞,避免急性闭角型青光眼再次发作。

Objective To investigate the efficacy and safety of laser peripheral iridoplasty combined with iridotomy for acute angle-closure glaucoma.Methods Twenty-six patients with acute primary angle-closure glaucoma(PACG)were recruited into the study.Each patient received the following IOP-lowering drugs: 1% pilocarpine,topical β-blocker,acetazolamide,mannitol.The IOP of each patient were controlled below 22 mmHg(1 mmHg=0.133 kPa).Then 26 cases(26 eyes) underwent laser peripheral iridoplasty at the iris root in all 360 degrees and had 30 laser spots.Then all cases were treated by laser iridotomy using Nd:YAG laser.Results Two hours after laser treatment,the intraocular pressure(IOP) was ≤21 mmHg and angle of anterior chamber opened again in all cases.Conclusion Laser peripheral iridoplasty combined with iridotomy can effectively reopen the closed anterior chamber angle and relieve pupil block in PACG patients who are experiencing acute attacks.