Background Argon laser peripheral iridoplasty (ALPI) is proved to be effective in lowering intraocular pressure (lOP) of patients with mild acute primary angle closure (APAC). It is unclear whether this laser tr...Background Argon laser peripheral iridoplasty (ALPI) is proved to be effective in lowering intraocular pressure (lOP) of patients with mild acute primary angle closure (APAC). It is unclear whether this laser treatment is equally efficient in managing patients with severe APAC. This study aimed peripheral iridotomy (LPI) on patients with refractory APAC, therapy. to evaluate the IOP-lowering efficacy of ALPI and laser who have previously responded poorly to intensive medical Methods Thirty-six patients (8 men and 28 women) were identified as medically refractory APAC, who still had ocular pain, red eye, hazy cornea, closed anterior chamber (AC) angle, and lOP of not less than 21 mmHg after two days or more of anti-glaucoma medication. All enrolled patients underwent ophthalmologic examinations including measurement of visual acuity (VA), best corrected VA (BCVA), lOP, biomicroscopy, and gonioscopy followed by ALPI immediately in the APAC eye and LPI in both eyes. Results All patients were affected unilaterally, with average age of (54.6±11.7) (range, 37.0-75.0) years old. The mean lOP value of the affected eyes dropped from (31.6±7.7) (range, 21.0-39.0) mmHg at enrollment to (18.4±8.7) (range, 10.0-27.0) mmHg 2 hours after ALPI. At follow-up day 7, the mean lOP value maintained at (14.8±4.2) (range, 9.0-21.0) mmHg, which was significantly different (P=0.000) compared with baseline. The average decrease of lOP in the APAC eyes was (16.8±7.4) (range, 12.0-21.0) mmHg. At follow-up three years later, the mean lOP of the APAC eyes stabilized at (16.3±3.2) (range, 9.0-20.0) mmHg with at least 180° of AC angle opened. Conclusion ALPI and LPI lower the lOP of medically refractory cases of APAC though they have responded poorly to anti-glaucoma medication.展开更多
目的 观察激光周边虹膜成形术联合周边虹膜切除术在治疗首次发作的急性闭角型青光眼的安全性和有效性.方法 闭角型青光眼患者30例59眼,诊断后首先药物降压,然后行氪激光周边虹膜成形术同时行YAG激光周边虹膜切除术,观察激光治疗前后超...目的 观察激光周边虹膜成形术联合周边虹膜切除术在治疗首次发作的急性闭角型青光眼的安全性和有效性.方法 闭角型青光眼患者30例59眼,诊断后首先药物降压,然后行氪激光周边虹膜成形术同时行YAG激光周边虹膜切除术,观察激光治疗前后超声生物显微镜监测下的房角开放度数及眼压的变化.结果 术前眼压为(27.14±18.49) mm Hg,术后2周眼压为(16.64±5.23) mm Hg,术后半年眼压为(18.24±6.17) mm Hg,术前与术后2周及术后半年眼压比较差异均有统计学意义(P<0.05).房角开放情况:平均房角开放度数:术前平均3点位(4.08±5.79)°,6点位(1.84±3.43)°,9点位(3.13±5.12)°,12点位(1.26±3.35)°,术后3点位(12.79±10.13)°,6点位(10.06±8.31)°,9点位(11.99±5.65)°,12点位(7.48±8.11)°.激光术后超声生物显微镜下的各方位房角开放度数与术前比较差异均有统计学意义(P<0.01).结论 氪激光周边虹膜成形术联合YAG激光周边虹膜切除术是治疗急性闭角型青光眼一种安全有效的方法,能有效加深患者房角,降低患者眼压.展开更多
基金This work was supported by grants from National Natural Science Foundation of China (No. 30921064 and No. 90820307), Ministry of Science and Technology of China (No. 2010IM030800), and the Beijing Municipal Health Bureau High-level Medical Professionals Promotion Project (No. 2011-3-044).
文摘Background Argon laser peripheral iridoplasty (ALPI) is proved to be effective in lowering intraocular pressure (lOP) of patients with mild acute primary angle closure (APAC). It is unclear whether this laser treatment is equally efficient in managing patients with severe APAC. This study aimed peripheral iridotomy (LPI) on patients with refractory APAC, therapy. to evaluate the IOP-lowering efficacy of ALPI and laser who have previously responded poorly to intensive medical Methods Thirty-six patients (8 men and 28 women) were identified as medically refractory APAC, who still had ocular pain, red eye, hazy cornea, closed anterior chamber (AC) angle, and lOP of not less than 21 mmHg after two days or more of anti-glaucoma medication. All enrolled patients underwent ophthalmologic examinations including measurement of visual acuity (VA), best corrected VA (BCVA), lOP, biomicroscopy, and gonioscopy followed by ALPI immediately in the APAC eye and LPI in both eyes. Results All patients were affected unilaterally, with average age of (54.6±11.7) (range, 37.0-75.0) years old. The mean lOP value of the affected eyes dropped from (31.6±7.7) (range, 21.0-39.0) mmHg at enrollment to (18.4±8.7) (range, 10.0-27.0) mmHg 2 hours after ALPI. At follow-up day 7, the mean lOP value maintained at (14.8±4.2) (range, 9.0-21.0) mmHg, which was significantly different (P=0.000) compared with baseline. The average decrease of lOP in the APAC eyes was (16.8±7.4) (range, 12.0-21.0) mmHg. At follow-up three years later, the mean lOP of the APAC eyes stabilized at (16.3±3.2) (range, 9.0-20.0) mmHg with at least 180° of AC angle opened. Conclusion ALPI and LPI lower the lOP of medically refractory cases of APAC though they have responded poorly to anti-glaucoma medication.
文摘目的 观察激光周边虹膜成形术联合周边虹膜切除术在治疗首次发作的急性闭角型青光眼的安全性和有效性.方法 闭角型青光眼患者30例59眼,诊断后首先药物降压,然后行氪激光周边虹膜成形术同时行YAG激光周边虹膜切除术,观察激光治疗前后超声生物显微镜监测下的房角开放度数及眼压的变化.结果 术前眼压为(27.14±18.49) mm Hg,术后2周眼压为(16.64±5.23) mm Hg,术后半年眼压为(18.24±6.17) mm Hg,术前与术后2周及术后半年眼压比较差异均有统计学意义(P<0.05).房角开放情况:平均房角开放度数:术前平均3点位(4.08±5.79)°,6点位(1.84±3.43)°,9点位(3.13±5.12)°,12点位(1.26±3.35)°,术后3点位(12.79±10.13)°,6点位(10.06±8.31)°,9点位(11.99±5.65)°,12点位(7.48±8.11)°.激光术后超声生物显微镜下的各方位房角开放度数与术前比较差异均有统计学意义(P<0.01).结论 氪激光周边虹膜成形术联合YAG激光周边虹膜切除术是治疗急性闭角型青光眼一种安全有效的方法,能有效加深患者房角,降低患者眼压.