激光周边虹膜切开术在急性闭角型青光眼的临床应用

Clinical application of laser peripheral iridotomy in acute angle closure glaucoma

目的观察激光周边虹膜切开术在治疗急性闭角型青光眼临床前期及间歇期的效果,探讨其作用机制。方法 49例78只眼闭角型青光眼行激光周边虹膜切开术,采用倍频532 nm激光烧灼、ND：YAG激光击穿周边虹膜,术后观察前房反应、眼压,随访3-12个月。结果所有眼术后均出现了虹膜炎性反应,1 d后消退;一过性眼压升高3眼（22-30 mmHg）,经处理后降至正常;前房出血2眼,1 d后吸收;角膜内皮损伤混浊2眼,3 d后消退。结论激光周边虹膜切开术并发症少,不影响降压效果,适合于急性闭角型青光眼临床前期及间歇期的治疗。

Objective To observe the therapeutic effects of laser peripheral iridotomy on angle closure glaucoma at early and interim period.Methods Forty-nine patients（78 eyes） with diagnosed angle closure glaucoma were received laser peripheral iridotomy.The laser with frequency of 532 nm and Nd： YAG（neodymium-doped yttrium aluminium garnet） was employed to perform on the middle of iris periphery.The intraocular pressure（IOP） and condition of the anterior chamber were observed after operation.The follow-up went for 3~12 months.Results Iris inflammation was found in all patients after operation;transient rising of IOP（22～30 mmHg）in 3 eyes;anterior chamber bleeding in 2 eyes and epithelial damage in the cornea in 2 eyes were also observed.All the complications disappeared within 1～3 days.Conclusion Laser peripheral iridotomy is safe and effective to treat angle closure glaucoma,especially for patients at early and interim stage since it is with few complications and do not have adverse effect on reducing IOP