氪离子与Q-开关Nd∶YAG激光联合应用行虹膜切开术

Combined Krypton and Q-switched Nd∶YAG Laser Peripheral Iridotomy: A Prospective Clinical Practice

目的 探讨治疗原发性闭角型青光眼的理想术式。方法 对 4 1例 (48眼 )原发性闭角型青光眼病例 ,采用氪离子激光与Q 开关Nd∶YAG激光联合应用的方法 ,行激光周边虹膜切开术。先用氪离子激光在虹膜面作分层击射 ,然后用Q 开关Nd∶YAG激光在此基础上作穿透性击射。结果 虹膜透切成功率为 10 0 0 % ,一次透切成功率为 97 9%。术后随访 1年 ,无一例发生击孔完全闭塞及青光眼发作。结论 联合激光虹膜切开术是预防和治疗原发性闭角型青光眼临床前期的有效术式 ,疗效确切 。

Objective To investigate the effective treatment of angle closure glaucoma. Methods Forty eight eyes (41 cases) underwent combined krypton and Q switched Nd∶YAG laser peripheral iridotomy. First using krypton laser to execute an iridotomy in 2/3 iris thickness, then Q switched Nd∶YAG laser was followed to complete a patent iridotomy. Intraocular pressure was measured 1-4 hours, 1 day ,1 and 2 weeks, 1, 3, 6 and 12 months after treatment. Results The successful rate of performing a patent combined iris perforation was 100 0%, and 97 9% of them were completed by once of shot. The intraocular pressure decreased to normal level and postoperative complications of this combined procedure appeared to be significantly less than those of either one of them. Forty eight eyes were followed by 1 year and none of the iris cavity was completely closed. Conclusions Combined iridotomy is simple and tends to be more preferable to the iris of Asian people. It appears that the combined krypton and Q switched Nd∶YAG laser peripheral iridotomy is effective and its long term effects are good.