氩离子/Nd:YAG联合激光虹膜切除术治疗闭角型青光眼的临床观察

Clinical Observation on Combined Argon and Nd∶YAG Laser Iridectomy in the Treatment of Angleclosure Glaucoma

为探索激光治疗闭角型青光眼的理想术式，对９８例（１５８只眼）原发性闭角型青光眼患者行联合激光虹膜切除术。先用氩离子激光在患眼虹膜面作一光凝斑，再用ＮｄＹＡＧ激光在此光凝斑上作穿透性击射。虹膜透切成功率为１００．０％，一次透切成功率为９７．５％。所有病例术后随访１年半，无一例发生孔洞闭塞，扩瞳试验均无青光眼发作症状。联合激光虹膜切除术操作简单、安全，可在门诊进行，且疗效确切，是治疗和预防由于瞳孔阻滞引起的急、慢性闭角型青光眼急性发作的理想术式。

he purpose of this study is to explore a rational method of laser surgery for angleclosure glaucoma. We have performed the combined argon and Nd∶YAG laser iridectomy on 158 eyes (98 cases) with primary angleclosure glaucoma. Following argon laser creating a laser photocoagulation spot, Nd∶YAG laser shot was performed to complete a patent iridectomy. The successful rate of performing a patent iris perforation was 1000% and 975% of them were completed by one shot. 158 eyes were followed up for 18 months after laser surgery. Among them no closure appeared in iris opening, and no acute onset of glaucoma was observed after mydriasis. The combined procedure is simple, convenient, safe and effective, and it can be completed in the outpatient department. This procedure may be considered as a rational method for preventing the acute onset of acute or chronic angleclosure glaucoma caused by pupillary block.