激光虹膜切开术联合周边虹膜成形术在原发性闭角疑似病例中的应用

Application of Laser Peripheral Iridotomy and Iridoplasty to Primary Angle Closure Suspects

目的通过评估前房径,观察虹膜切开术联合周边虹膜成形术治疗原发性闭角疑似病例(primary angle closure suspect,PACS)的临床疗效。方法 PACS患者24例48只眼,分为两组,采用患者自身另1只眼做对照。A组患者24只眼,采用虹膜切开联合周边虹膜成形术治疗;B组患者24只眼,采用虹膜切开术治疗。使用Pentacam测量治疗前后的前房径,测定平均前房深度(anterior chamber depth,ACD)、前房容积(anterior chamber volume,ACV)和前房角,比较两种方法的临床疗效。结果在两组患者治疗后,ACD和ACV平均值显著增加。A组患者治疗区中间至外围的ACD值增加较B组更明显。两组患者治疗后的眼内压和并发症发生率比较,差异无显著意义。结论激光周边虹膜成形术联合虹膜切开术可有效的抑制PACS患者有害的前房径变化,是一种安全的治疗方法。

Objective To compare the effect of traditional peripheral iridotomy with that of laser peripheral iridotomy and iridoplasty on primary angle closure suspects by evaluating anterior chamber diameters.Methods Altogether 24 patients（48 eyes） were divided into two groups： the iridotomy group as the control group,and the peripheral iridotomy plus iridoplasty group as the combined group. Their anterior chamber diameters before and after the treatment were measured with Pentacam respectively,and the mean anterior chamber depths（ ACD）,anterior chamber volumes（ ACV） and anterior chamber angles were assessed. The results of the two groups were compared.Results After the treatment,the means of ACV and ACD increased significantly in both groups,the mid-to-peripheral ACD grew greater in the LPI plus iridoplasty group than in the conventional LPI group,and no great difference was found between the groups both in intraocular pressure change and post-LPI complication.Conclusions Combination of laser peripheral iridotomy and iridoplasty may be a safe and effective solution for primary angle closure suspect.