氟激光和掺钕钇铝石榴石激光联合应用进行周边虹膜切除术

Combined argon and neodymium: yttrium aluminum garnet laser peripberal iridectomy:a new approach in clinical practice

为了探讨治疗闭角型青光眼的理想术式，对１５１例２００只原发性急、慢性闭角型青光眼，部分混合型青光眼行联合激光周边虹膜切除术。先用氖激光在术眼虹膜面作分层击射，达２／３～３／４基质层厚；然后用掺钕钇铝石榴石激光（ｎｅｅｄｙｍｉｕｍ：ｙｔｔｒｉｕｍａｌｕｍｉｎｕｍｇａｒｎｅｔ，Ｎｄ：ＹＡＧ）作穿透击射。虹膜透切率为１００．０％，１次透切成功率为９５．０％，术中、术后并发症的发生率明显较单独术式低。随访时间在２年以上者为１６１只眼。随访结果表明联合激光手术的远期疗效显著，是适宜于亚洲人虹膜特点的较为理想术式，建议在门诊推广应用。

Laser peripheral iridectomy was performed on 200 eyes(151 cases)with primary acute or chronic angle-closure glaucoma and partly with mixed glaucoma,Following argon laser creating an iridectomy in 2/3-3/4 iris thickness,neodymium:yttrium aluminum garnet(Nd :YAG)laser shot was required to complete a patent iridectomy, This kind of procedure is simple and tends to be more prefer-able to Asian people with heavily pigmented and thick irides for which a perforation is difficult to be per-formed. The successful rate of performing a patent iris perforation was 100.0%and 95.0%of them were completed by once of shot.The intraoperative and postoperative complications of this combined procedure appeared to be significantly less than those of either one of them。161 eyes were followed for more than 2 years.The objective criteria demonstrate that the long-term therapeutic effects of this com-bined technique are very good,It is recommended to use the procedure extensively in the out-patient clinics.