准分子激光治疗原发性青光眼的临床观察

Clinical observation of primary glaucoma treated by excimer laser

目的 探讨准分子激光治疗原发性青光眼的效果。 方法 原发性青光眼 5 7眼 ,其中 5 0眼为开角型青光眼 ,7眼为闭角型青光眼 ,用ArF准分子激光行巩膜瓣下巩膜造瘘。 结果 5 7眼术前平均眼压 (33 2 3± 18 45 )mmHg ,术后平均 (15 2 3± 6 45 )mmHg。治疗前后眼压具有显著性差异 (P <0 0 0 1)。 5眼闭角型青光眼术后眼压波动较大 ,其中 2眼改行小梁切除术。术后视力保持或改善占 87 7% ,前房深度、视野及视杯无明显改变 ,无 1例出现较严重的术后并发症。 结论 准分子激光巩膜瓣下巩膜造瘘是一种治疗原发性开角型青光眼的行之有效的手术方法。

Objective To study the therapeutic effects of primary glaucoma treated by excimer laser. Methods 57 eyes of primary glaucoma,in which 50 eyes were open angle glaucoma,and 7 eyes were angle closure glaucoma,were treated by sclerostomy under the scleral flap using NIDEK EC 5?000 ArF excimer laser. Results The average intraocular pressure of 57 eyes were (33 23±18 45)?mmHg in 57 eyes preoperation,and were (15 23±6 45)mmHg postoperation.The differences of pre ?and post operative intraocular pressures were statistically significant( P <0 001).The intraocular pressures of angle closure glaucoma in 5 eyes were abnormal,of which 2 eyes were retreated by trabeculectomy.Visual acuity was tended to be stabilized and improved,in 87 7% of the eyes treated with laser surgery. The anterior chamber depth,the visual field and the optic cup had no obvious changes.None of the cases showed serious postoperative complications. Conclusion Sclerostomy under the scleral flap by excimer laser is an effective surgery for the treatment of primary open angle glaucoma.