联合激光手术治疗中晚期闭角型青光眼

The treatment of middle and late stages of closure angle glaucoma with combined laser surgery

目的 评价联合激光手术治疗中、晚期闭角型青光眼的临床效果及应用价值。方法 采用随机对照临床研究方法，将５２例（７８眼）中、晚期慢性闭角型青光眼患者分为两组。联合激光手术组（氩激光周边虹膜成形术联合氩激光加Ｎｄ：ＹＡＧ激光周边虹膜切除术）３２例（４６眼），小梁切除术组２０例（３２眼），其中８例为同一患者左右眼对照。结果 两组比较，联合激光手术组，术后早期眼压控制率为９５．６５％（Ｐ＜０．０５），术后视力提高迅速而且稳定（Ｐ＜０．０５），术后并发症轻而少（Ｐ＜０．０５），术后无需加用抗青光眼药物治疗的患者明显增多（Ｐ＜０．０５）。结论 联合激光手术安全有效，可作为中、晚期闭角型青光眼一种可行的治疗方法。

Objective To compare the clinical results of combined laser surgery with trabeculectomy in the treatment of middle and late stages of closure angle glaucoma. Methods 78 eyes of 52 cases with middle and late stages of chronic angle closure glaucoma were randomly divided into two groups,46 eyes were treated by a laser technique which included Ar- gon laser peripheral iridoplasty and Nd: YAG laser iridectomy, and 32 eyes were treated by trabeculectomy . 8 cases among them were treated by different treatment ( make a compare between themselves eyes) . Results Postoperatively, the intraocular pressures(IOP) were controlled within normal limit in 95.65% ( P <0.05) for the combined lased group at the early stage, cases necessary for the use of anti-glaucoma drug decreased (P<0.05) , the visual acuity improved quickly and steadily, and the complications were less than that in the trabeculectomy group(P < 0.05) . Conclusion The combined laser surgery is safe and effective, and has certain value in clinical application.