激光虹膜周边成形术在原发性急性闭角型青光眼急性发作期的疗效观察

Clinical observation of acute attack of primary angle-closure glaucoma treated by krypton laser peripheral iridoplasty

摘要:

目的:观察激光虹膜周边成形术在原发性急性闭角型青光眼急性发作期的治疗效果。方法:观察85例85眼经基础治疗1h后眼压≥40mmHg者45眼选入激光组;余40眼列入药物组。观察两组治疗前、后30min,治疗后60,120min;24h后患者的症状、视力、角膜水肿程度、前房反应、周边前房深度、眼压降至21mmHg以下所用的时间和24h后房角开放情况。结果:治疗1h后,激光组较药物组眼痛症状缓解明显,起效快;视力提高快、幅度大;角膜混浊程度恢复快。两组周边前房都变深;治疗后30min眼压分别与同组治疗前比较无统计学差异;治疗后60,120min;24h眼压分别与同组治疗前比较均有统计学差异(P<0.05);治疗后60,120min两组眼压比较有统计学差异(P<0.05);治疗后30min和24h两组无统计学差异;眼压降至21mmHg以下所用的时间,两组差异有统计学意义(P<0.05);24h后房角开放率两组差异有统计学意义(P<0.05)。结论:激光虹膜周边成形术对原发性急性闭角型青光眼急性发作期的治疗效果优于传统的全身药物治疗,是一种快速、安全和有效的方法。

Abstract:

AIM:To observe the effect of krypton laser peripheral iridoplasty(LPI) for acute attack of primary angle-closure glaucoma(PACG).METHODS:Eighty-five patients 85 eyes diagnosed with the acute attack of PACG were prescribed the base treatment.One hour later,they were randomized into two groups:the LPI group 45 eyes with IOP still above or equal 40 mmHg and the medical treatment group 40 eyes with IOP below 40mmHg.Symptoms,visual acuity,corneal clarity,the depth and flare of the anterior chamber,IOP were observed before treatment and 30,60,120 minutes,24 hours after treatment.And the time used to lower IOP to 21 mmHg and the opening of anterior chamber were observed.RESULTS:After one hour,compared with the medical treatment group,the LPl group:symptoms and the corneal edema dissolved faster;the visual acuity rose more and fasten,the differences were statistically significant in IOP at 60,120 minutes after treatment in the two groups,however,no statistical difference at 30 minutes and 24 hours.Compared with IOL before treatment,there was no statistical difference at 30 minutes after treatment,but at 1,2,24 hours after treatment there was statistical difference in LPI group,so was the medical treatment group.The time used to lower IOP to 21mmHg and the opening of anterior chamber were statistically different in two groups(P<0.05).CONCLUSION:With an effective method,LPI can rapidly reduce the IOP of the acute attack of the PACG,especially better than medical treatment.