激光周边虹膜切除术后慢性闭角型青光眼的手术疗效评价

Evaluation on the efficacy of surgery for chronic angle-cloure glaucoma after laser peripheral iridectomy

目的评价激光周边虹膜切除术后慢性闭角型青光眼的手术疗效。方法对激光周边虹膜切除术后慢性闭角型青光眼20例（30只眼）行小梁切除联合眼球筋膜切除及羊膜移植术，术后随访12个月，对手术前后视力、眼压、视野、眼底杯盘比值及并发症进行观察分析。结果术后1周眼压（11．60±1．96）mmHg（1mmHg=0．133kPa），与术前眼压（26．84±8．01．）mmHg相比较，差异有统计学意义（P〈0．05）。末次随访眼压（16．63±1．44）mmHg，所有患者眼压控制较好。术后视力、视野、眼底杯盘比值分别与术前比较无明显变化，随访期间未发现严重并发症。结论小梁切除联合眼球筋膜切除及羊膜移植术是治疗激光周边虹膜切除术后慢性闭角型青光眼一种安全有效的手术治疗方式。

Objective To evaluate the clinical efficacy of trabeculectomy and tenonectomy combined with biological amniotic membrane transplantation in the treatment of chronic angle-closure glaucoma after laser peripheral iridectomy. Methods Thirty eyes of 20 cases with chronic angle-closure glaucoma after laser peripheral iridectomy were selected and treated with trabeculetomy and tenonectomy combined with biological amniotic membrane transplantation. The patients were followed up for 12 months （IOP）. Visual activity, intraocular pressure （ IOP）, visual field, C/D ratio of optic disc and complications after surgery were observed and analyzed. Results At 1 week postoperatively,IOP of 30 eyes were （ 11.60±1.96） mmHg （ 1 mmHg = 0. 133 kPa）, compared with that of （26.84±8.01 ） mmHg preoratively, the difference was statistically significant （ P 〈 0.05 ）. At the end of follow-up time, all patients of IOP were controlled normal range （ 16.63±1.44） mmHg. There was no difference in visual activity, visual field or C/ D ratio postperatively compared with those of preopratively. No serious postoperative complication occurred during the following time. Conclusion The combined surgery of tenonectomy, trabeeulectomy and anmiotic memebrane transplantation for the treatment of chronic angle-closure glaucoma after laser peripheral iridectomy is safe and effective.