激光虹膜周边成形术治疗原发性闭角型青光眼急性发作的临床效果观察

Clinical effect observation of laser peripheral iridoplasty in treatment of acute attack of primary angle-closure glaucoma

目的通过探讨激光虹膜周边成形术治疗原发性闭角型青光眼急性发作的临床疗效，旨在为有效恢复视力并提高患者生活质量提供理论依据。方法选择2012年1月～2015年1月在我院接受治疗的原发性闭角型青光眼急性发作患者150例。患眼150眼，随机分为研究组和对照组，对照组患者应用小梁切除术治疗，研究组患者应用激光虹膜周边成形术治疗，对比两组患者治疗后1个月、3个月、6个月的视力变化及术后1个月、3个月、6个月眼压变化；同时对比治疗后两组患者房角开放率、中央前房深度、光敏度、中央角膜内皮细胞密度。结果研究组患者术后1个月、3个月、6个月视力水平分别为（0．59±0．09）、（0．61±0．10）、（0．62±0．13），均显著优于对照组；研究组患者术后1个月、3个月、6个月眼压分别为（15．07±1．02）mmHg、（14．35±1．01）mmHg、（13．38±1．05）mmHg，均显著优于对照组。差异有统计学意义（P〈0．05）；研究组房角开放率为89．33％、中央前房深度（0．74±0．11）mm、中央角膜内皮细胞密度为（2615．84±2．16）个／mm2．光敏度（26．54±1．03），均显著优于对照组（P〈0．05）。结论激光虹膜周边成形术治疗原发性闭角型青光眼急性发作能快速降低眼压、提高视力，是一种快速有效的治疗方式。

Objective To explore the clinical efficacy of laser peripheral iridoplasty in the treatment of acute attack of primary angle-closure glaucoma in order to provide theoretical basis for effective eyesight restoration and patients＇ life quality improvement. Methods A total of 150 patients（ 150 affected eyes） with acute attack of primary angle-closure glaucoma treated in our hospital from January 2012 to January 2015 were selected and randomly and evenly divided into the study group and the control group. The control group was given trabeculectomy and the study group was given laser peripheral iridoplasty. The posttreatment 1-month, 3-month and 6-month eyesight changes and the posttreatment 1-month, 3-month and 6-month intraocular pressure changes of the two groups were compared. Meanwhile, the post- treatment chamber angle open rates, central anterior chamber depth, light sensitivity and central corneal endothelial cell density of the two groups were compared. Results In the study group, the postoperative 1-month, 3-month and 6- month eyesight levels were （0.59±0.09）, （0.61±0.10） and （0.62±0.13） respectively, which were all significantly better than those in the control group. In the study group, the postoperative 1-month, 3-month and 6-month intraocular pressure was （15.07±1.02） mmHg, （14.35±1.01） mmHg and （13.38±1.05） mmHg respectively, which were all significantly better than those in the control group, with statistically significant differences （P〈0.05）. In the study group, the chamber angle open rate was 89.33%, the central anterior chamber depth was （0.74±0.11） mm, the central corneal endothelial cell density was （2615.84±2.16）/mm^2 and the light sensitivity was （26.54±1.03）, which were all significantly better than those in the control group（P〈0.05）. Conclusion In the treatment of acute attack of primary angle-closure glaucoma, laser pe- ripheral iridoplasty can rapidly reduce intraoeular pressure and improve eyesight, which is a fast and effective treatment method.