慢性闭角型青光眼手术治疗的探讨

Study on Surgical Treatment of Chronic Angle-Closure Glaucoma

在我国,原发性闭角型青光眼的发病率远远超过开角型青光眼。特别是慢性闭角型青光眼(以下简称慢闭),由于症状轻微,发作后又易于缓解,甚至有些病例极似开角型青光眼,因之易于疏忽或误诊。其结果可由于反复小发作而致前房角进行性器质性闭锁,进而发生视神经不可逆性损害。因而对此病的防治就有着更重要的意义。通过长期临床实践,我们体会到。

During 1974～1985. 764 patients with angle-closure glaucoma were operated on, of whom 343 suffered from CACG. Cases in the preclinical and intermittent stages (Group A) were treated by peripheral iridectomy. Cases in the chronic progressive and absolute stages (Group B) underwent Scheies surgery or trabeculectomy. The short-term results of the various operations were as follows:1) Frequency of controlling IOP below 21 mmHg was nearly the same in the two Groups.2) There were obvious differences in maintenance of preoperative visual acuity level between the two Groups.The visual acuity of Group A was better than that of Group B. 3) The complications of Group B were more serious than those of Group A.4) Gonioscopic findings showed that when the chamber angle was entirely open or open over more than 2/3 of the angle circumference, peripheral iridectomy could be successful.The long-term follow-up showed that IOP in 95% of the 52 eyes receiving peripheral iridectomy was normal, but that in.39.1% of the 23 eyes of Group B IOP was higher than 25 mmHg. Thus CACG should be diagnosed and operated on as early as possible.