目的:探讨532nm激光+Nd:YAG激光周边虹膜切除术治疗早期瞳孔闭锁性青光眼的安全性和有效性。方法:将符合标准的56例瞳孔闭锁性青光眼患者按完全随机对照顺序编号,分成A,B两组。A组28例接受ND:YAG激光治疗,B组28例接受532nm激光+ND:YAG激光治疗,通过对视力、眼压、激光孔洞、视野和房角等观察,重点观察眼压控制情况。结果:经过2a的临床随访观察,眼压:A组术前(28.32±3.43)mmHg,术后(24.82±3.27)mmHg,采用配对t检查(tA=3.256)差异无统计学意义,A组眼压控制不理想;B组术前(28.79±3.63)mmHg,术后(15.31±3.18)mmHg,采用配对t检查(tB=26.315,P<0.05)差异有统计学意义;A,B两组激光治疗后眼压控制情况比较,差异有统计学意义(χ2=42.23,P<0.05)。视力:A,B两组治疗前后经t检验,A组:tA=2.375,B组:tB=2.362,视力变化无统计学意义,A,B两组间比较差异也无统计学意义(χ2=3.845)。并发症:A,B两组均无较严重并发症发生。结论:532nm激光+ND:YAG激光周边虹膜切除术是治疗早期瞳孔闭锁性青光眼的安全、有效方法,能明显降低眼压,保存视功能。

AIM:To explore the safety and effectiveness of 532nm laser + Nd:YAG laser in peripheral iridectomy treatment for early pupil closure glaucoma.METHODS:Fifty-six cases of pupil closure glaucoma who complied with the standards were selected and numbered randomly,and then devided into group A and B,group A(28 cases)took ND:YAG laser,group B (28 cases) took 532nm laser +ND:YAG laser treatment.The results of visual acuity,intraocular pressure (IOP),laser hole,vision and a cornerstone were observed,and the key observation was IOP control.RESULTS:After two years of clinical follow-up,IOP:(28.32±3.43)mmHg for group A before the operation,and (24.82±3.27)mmHg after the operation,using matching t-test(tA=3.256,P>0.05),the results had no statistically significant differences,IOP control for group A was not ideal;(28.79±3.63)mmHg for group B before the operation,and (15.31±3.18)mmHg after the operation,using matching t-test (tB=26.315,P<0.05),the results had statistically significant differences,the results of laser treatment for IOP control on group A and B,the difference was statistically significant (χ2= 42.23,P<0.05).Vision:by t-test,group A:tA=2.375,group B:tB=2.362.Neither the vision changes for group A and B nor the difference between group A and B had statistical significance(χ2=3.845).Complications:neither group A nor B had serious complications.CONCLUSION:532nm laser + ND:YAG laser treatment is a safe and effective method for peripheral iridectomy on early pupil closure glaucoma,it could significantly reduce IOP,preserve the visual function.

R779.6