激光周边虹膜成形术治疗高褶虹膜综合征致房角关闭的临床观察

A clinical study on the treatment of plateau iris induced primary angle closure glancoma by laser peripheral iridoplasty

目的观察激光周边虹膜成形术(1aser peripheral iridop lasty,LPI)对高褶虹膜综合征所致房角关闭的治疗效果。方法对15例(25只眼)高褶虹膜综合征所致房角关闭的周边虹膜切除术后进行激光周边虹膜成形术治疗,术后1周应用前房角镜观察房角粘连情况。随访2～12个月,平均8个月。结果术后3个月25只眼的平均眼压和平均用药指数从术前的(21.7±2.3)mmHg和(3.6±1.2)降到(16.8±1.3)mmHg和(1.4±0.95),激光周边虹膜成形术后一周,部分患者周边虹膜前粘连减少、周边虹膜变薄,随诊期间未发现前房角进行性粘连及高眼压。结论激光虹膜成形术可以明显加深高褶虹膜综合征所致房角关闭的周边前房,增宽房角入口,从而预防房角粘连的进一步进展。

Objective To evaluate the therapeutic effect of laser peripheral iridoplasty on plateau iris induced angle closure.Methods 25 eyes of 15 patients with plateau iris induced angle closure received laser peripheral iridotomy.The synechia with gonioscope one week after the surgeries were observed.Results Three month after the surgeries,the average IOP of 25 eyes decline from（21.7±2.3） mmHg to（16.8±1.3） mmHg.The average medical index of 25 eyes declined from 3.6±1.2 to 1.4±0.95.One week after the surgeries,some patients showed less PAS,thinner peripheral iris.During the follow-up,there was neither progressive synechia nor increasing IOP.Conclusion laser peripheral iridoplasty can deepen and widen the entrance of the angle in plateau iris induced angle closure.It can prevent the progression of synechial angle.