激光周边虹膜切除术治疗早期闭角型青光眼的临床观察

Clinical observation on laser peripheral iridectomy treatment for early stage angle-closure glaucoma

目的:YAG激光周边虹膜切除术治疗闭角型青光眼的疗效及并发症的临床观察。方法:本组病例20例(25眼),诊断为闭角型青光眼临床前期、前驱期的22眼,3眼为间歇期。使用Nd:YAG激光机在虹膜中周部单脉冲击射均为一次透切成功,随访3～12mo,观察疗效及并发症。结果:25眼激光切孔1次手术成功率100%。术后均出现了虹膜炎性反应,1～3h内一过性眼压升高5眼,前房出血4眼,角膜内皮损伤1眼,全部并发症于术后1～3d消失。无切孔后晶状体混浊及孔洞闭塞并发症发生。术后周边前房及房角增宽,眼压<18mmHg。结论:Nd:YAG激光周边虹膜切除术治疗闭角型青光眼安全有效,对早期患者效果更佳,适宜在基层医院推广。

AIM： Clinical observation on laser pheripheral iridectomy treatment for angle-closure glaucoma and the complications. METHODS： Twenty patients （25 eyes） were diagnosed by angle-closure glaucoma, of them, 22 eyes was at early clinical stage and 3 eyes at intermittent stage. Nd： YAG laser singe pulse launch was performed on the middle of iris periphery. Following-up time was for 3-12 months, and the clinical effect and complications were observed. RESULTS： All 25 eyes was finished in one time （success rate 100%）. Iris inflammation reaction was found in all the patients after operation, in which 5 eyes rose the intraocular pressure （lOP） within 1-3 hours, 4 eyes were presented anterior chamber bleeding, and 1 eye had epithelial damage in the cornea. All the complications disappeared within 1-3 days. The complications such as crystalline turbid, hole obstruction were not found. Peripheral anterior chamber and chamber anger were got wide and IOP 〈 18mmHg. CONCLUSION ： Nd ： YAG laser peripheral iridectomy is a safe and effective method to treat angle-closure glaucoma, especially for the patients at early stage. It is suitable for primary hospitals.