LPI治疗原发性房角关闭的并发症研究进展

Research progress on complications of primary angle closure treated by laser peripheral iridotomy

青光眼是导致不可逆性失明的主要原因,大约四分之一的病例是由原发性闭角型青光眼(PACG)引起的。激光周边虹膜切开术(LPI)被认为预防原发性房角关闭(PAC)患者房角关闭及治疗PACG患者反复发作的一线治疗方法。然而,LPI激光治疗所带来的眼部并发症也逐渐被人们认识,如一过性眼压升高、前葡萄膜炎、虹膜出血、角膜内皮细胞损害、晶状体损伤、角膜水肿、眩光、复视和视网膜损伤等,均严重影响了患者的视力。因此,如何有效减少并发症的发生是激光虹膜切除术的关键。

Glaucoma is the leading cause of irreversible blindness,with primary angle closure glaucoma(PACG) causing about a quarter of all cases. According to the classification of natural course of disease,PACG can be classified as a stage in the natural course of primary angle closure(PAC). The laser peripheral iridotomy(LPI) is considered as the preferred treatment for PAC patients at all stages,and can effectively prevent primary angle closure suspect(PACS) and PAC patients from progressing to PACG. However, the ocular complications caused by LPI laser therapy are gradually recognized,such as the transient elevated intraocular pressure, anterior uveitis,iridemia,corneal endothelial cell damage,lens injury,corneal edema,glare, diplopia,retinal injury,etc.,which seriously affect the visual quality of patients. Therefore, when performing laser iridectomy on PAC patients,surgeons should fully grasp the surgical indications and treatment timing to reduce the occurrence of adverse reactions and complications.