激光周边虹膜成形术联合激光周边虹膜切除术治疗原发性闭角型青光眼急性发作期的临床疗效及安全性分析

Clinical efficacy and safety of laser peripheral iridoplasty combined with laser peripheral iridectomy in the treatment of acute attack of primary angle-closure glaucoma

目的探究激光周边虹膜成形术(LPIP)联合激光周边虹膜切除术(LPID)治疗原发性闭角型青光眼急性发作期的临床疗效及安全性。方法48例(66只患眼)原发性闭角型青光眼急性发作期患者作为研究对象,按随机数字表法分为对照组(24例,32只患眼)和观察组(24例,34只患眼)。对照组进行LPID,观察组进行LPID联合LPIP。比较两组治疗前后视力及眼压变化情况、术后并发症发生情况。结果观察组术后1、3、6个月的视力分别为(0.51±0.09)、(0.64±0.17)、(0.66±0.15),均高于对照组的(0.42±0.14)、(0.47±0.13)、(0.52±0.08),差异有统计学意义(P<0.05)。观察组术后1、3、6个月的眼压分别为(15.04±2.69)、(13.47±2.36)、(12.52±2.48)mm Hg(1 mm Hg=0.133 kPa),均低于对照组的(23.76±2.28)、(21.79±2.11)、(17.53±2.46)mm Hg,差异有统计学意义(P<0.05)。观察组术后并发症发生率0低于对照组的12.50%(4/32),差异有统计学意义(χ2=4.524,P=0.033<0.05)。结论LPIP联合LPID治疗原发性闭角型青光眼急性发作期的临床效果显著,且术后并发症少,治疗安全性高,值得推广。

Objective To investigate the clinical efficacy and safety of laser peripheral iridoplasty(LPIP)combined with laser peripheral iridectomy(LPID)in the treatment of acute attack of primary angleclosure glaucoma.Methods A total of 48 patients(66 involved eyes)with acute attack of primary angle-closure glaucoma were divided into control group(24 cases,32 involved eyes)and observation group(24 cases,34 involved eyes)according to random numerical table.The control group was treated with LPID,and the observation group was treated with LPID combined with LPIP.The changes of vision and intraocular pressure before and after treatment,and the occurrence of postoperative complications were compared between the two groups.Results At 1,3 and 6 months after operation,the vision of the observation group were(0.51±0.09),(0.64±0.17)and(0.66±0.15),which were all higher than(0.42±0.14),(0.47±0.13)and(0.52±0.08)of the control group,and the difference was statistically significant(P<0.05).At 1,3 and 6 months after operation,the intraocular pressure of the observation group were(15.04±2.69),(13.47±2.36)and(12.52±2.48)mm Hg(1 mm Hg=0.133 kPa),which were all lower than(23.76±2.28),(21.79±2.11)and(17.53±2.46)mm Hg of the control group,and the difference was statistically significant(P<0.05).The incidence of complications 0 of the observation group was lower than 12.50%(4/32)of the control group,and the difference was statistically significant(χ2=4.524,P=0.033<0.05).Conclusion LPIP combined with LPID has remarkable clinical effect in the treatment of acute attack of primary angle-closure glaucoma with less complications and high safety,which is worthy of promotion.