外路小梁切开术联合虹膜周边切除治疗原发性闭角型青光眼36例

Treatment of primary angle-closure glaucoma with external trabeculotomy combined with peripheral iridectomy: report of 36 cases

目的研究外路小梁切开术联合虹膜周边切除治疗原发性闭角型青光眼的临床疗效。方法选取36例(36眼)原发性闭角型青光眼患者均接受外路小梁切开术联合虹膜周边切除术治疗,比较治疗后1、3个月的房角与眼压变化情况。结果 (1)与术前比较,术后1个月、3个月患者眼压得到明显改善,差异具有统计学意义(P<0.05)。(2)术后3个月,有1眼可以观察到眼压上升,其房角部位裂隙消失,虹膜周边出现了粘连现象。(3)治疗后视力均较治疗前显著提高,差异有统计学意义(P<0.01)。(4)接受治疗后,36例患者均存在前房出血症状,有2眼(5.6%)属于中等量,34眼(94.4%)属于少量出血。结论外路小梁切开术与虹膜周边切除术联合使用,可有效缓解患者疾病症状,取得显著疗效,值得临床推广应用。

Objective To investigate the clinical effect of external trabeculotomy combined with peripheral iridectomy in the treatment of primary angle-closure glaucoma（ PACG）. Methods External trabeculotomy combined with peripheral iridectomy was performed on 36 eyes in 36 patients with PACG. The anterior chamber angle and intraocular pressure were compared at 1 month,and 3 months after the operation. Results（ 1） Compared with the preoperative intraocular pressure,patients＇ intraocular pressure improved obviously at 1 month,and 3 months after the operation,with statistically significant differences（ P〈0. 05）.（ 2） At 3 months after operation,one eye was observed the elevation of intraocular pressure,disappearance of anterior chamber angle fracture and adhesion of iris periphery.（ 3） The patients＇ visual acuity improved obviously after treatment,with statistically significant difference（ P〈0. 01）.（ 4） After treatment,the postoperative anterior chamber hemorrhage was found in 36 eyes. Among them,2 eyes（ 5. 6%） belonged to moderate hemorrhage and 34 eyes（ 94. 4%） belonged to mild hemorrhage. Conclusion External trabeculotomy combined with peripheral iridectomy can effectively relieve the symptoms of the disease,achieving a significant effect,and is worthy of clinical application.