氩激光周边虹膜成形术治疗急性闭角型青光眼急性发作期临床疗效观察

Clinical observation of argon laser peripheral iridoplasty in the treatment of acute attack of acute angle closure glaucoma

目的分析氩激光周边虹膜成形术治疗急性闭角型青光眼急性发作期的临床效果。方法 88例急性闭角型青光眼急性发作期患者,按照奇偶法分为对照组和观察组,每组44例(44只眼)。对照组患者接受常规药物治疗,观察组患者接受氩激光周边虹膜成形术治疗。比较两组患者治疗前后患眼和对侧眼角膜内皮细胞数量变化情况及视力、眼压变化情况。结果治疗4周后,观察组患眼角膜内皮细胞数量为(2012.24±502.27)个/mm^(2),对侧眼为(2752.37±580.27)个/mm^(2);对照组患者患眼角膜内皮细胞数量为(2285.46±535.55)个/mm^(2),对侧眼为(2432.22±550.13)个/mm^(2);治疗前,两组患者患眼及对侧眼角膜内皮细胞数量比较差异无统计学意义(P>0.05);治疗4周后,观察组患者患眼角膜内皮细胞数量低于对照组,对侧眼角膜内皮细胞数量高于对照组,差异具有统计学意义(P<0.05)。治疗4周后,观察组患者视力为(0.93±0.11)、眼压为(16.22±1.84)mm Hg(1 mm Hg=0.133 kPa),对照组患者视力为(0.82±0.08)、眼压为(23.36±2.14)mm Hg;治疗前,两组患者视力、眼压比较差异无统计学意义(P>0.05);治疗4周后,两组患者视力、眼压均优于治疗前,且观察组患者视力、眼压均优于对照组,差异有统计学意义(P<0.05)。结论氩激光周边虹膜成形术治疗急性闭角型青光眼急性发作期患者会对患侧角膜内皮细胞产生一定影响,但是能够有效改善患者对侧眼角膜内皮细胞数量,调节患者视力及眼压。

Objective To analyze the therapeutic effect of argon laser peripheral iridoplasty in the treatment of acute attack of acute angle closure glaucoma. Methods 88 patients in the acute attack of acute angle closure glaucoma were randomly divided into control group and observation group, with 44 cases(44 eyes) in each group.Patients in the control group received conventional medical treatment, while patients in the observation group received argon laser peripheral iridoplasty. The changes in the number of corneal endothelial cells of the affected and contralateral eyes, visual acuity and intraocular pressure were compared between the two groups before and after the treatment.Results After 4 weeks of treatment, the observation group had a number of corneal endothelial cells of(2012.24±502.27) cells/mm^(2) for the affected eye and(2752.37±580.27) cells/mm^(2) for the contralateral eye, while the control group had a number of corneal endothelial cells of(2285.46±535.55) cells/mm^(2) for the affected eye and(2432.22±550.13) cells/mm^(2) for the contralateral eye. Before the treatment, the differences in the number of corneal endothelial cells of the affected and contralateral eyes between the two groups were not statistically significant(P>0.05). After 4 weeks of treatment, the number of corneal endothelial cells of the affected of the observation group was lower than that of the control group, and the number of corneal endothelial cells of the contralateral eyes was higher than that of the control group, and the differences were statistically significant(P>0.05). After 4 weeks of treatment, the observation group had a visual acuity of(0.93±0.11)° and an intraocular pressure of(16.22±1.84) mm Hg(1 mm Hg = 0.133 kPa), while the control group had a visual acuity of(0.82±0.08) and an intraocular pressure of(23.36±2.14) mm Hg. Before the treatment, the differences in visual acuity and intraocular pressure between the two groups were not statistically significant(P>0.05). After 4 weeks of treatment, the visual acuity and the intraocular pressure of each group were better than those before the treatment, and the visual acuity and the intraocular pressure of the observation group were better than those of the control group, and the differences were statistically significant(P<0.05). Conclusion Argon laser peripheral iridoplasty has a certain effect on the corneal endothelial cells of the effected eyes in the treatment of acute attack of acute angle closure glaucoma. But it can improve the number of corneal endothelial cells in the contralateral eye, and adjust the visual acuity and the intraocular pressure in patients.