方法：回顾性病例系列。研究对象为2013-01/2015-06来我院就诊后行激光虹膜周切术的患者362例512眼。统计分析激光虹膜周切术中和术后3mo内各类并发症的情况。主要指标为虹膜出血、眼压、虹膜睫状体炎、角膜和晶状体损伤等发生率。

结果：患者中女274例416眼，男88例96眼。原发性闭角型青光眼248眼、原发性房角关闭108眼、原发性房角关闭可疑72眼、原发性闭角型青光眼尚无任何青光眼体征的对侧眼66眼、存在瞳孔阻滞因素的继发性青光眼或高眼压18眼。并发症包括虹膜出血107眼(20.9%)、暂时性眼压升高85眼(16.6%)、虹膜睫状体炎14眼(2.7%)、角膜损伤10眼(2%)、晶状体损伤2眼(0.4%)、减压性视网膜病变1眼(0.2%)、渗出性视网膜脱离2眼(0.4%)。虹膜出血在急性闭角型青光眼患者中发生率最高(33.7%，P=0.019)，暂时性眼压升高在慢性闭角型青光眼患者中发生率最高(23.0%，P=0.047)。

结论：Nd：YAG激光虹膜周切术最常见的并发症包括虹膜出血和暂时性眼压升高。闭角型青光眼患者是否更容易发生这两种并发症，还需要更大样本量做进一步分析。需重视减压性视网膜病变和渗出性视网膜脱离等少见严重并发症。根据患者的具体病情，选择激光虹膜周切术的适应证和时机。

METHODS:This was a retrospective case series. Totally 362 cases(512 eyes)were involved in the treatment of Nd:YAG laser peripheral iridotomy in Xijing Hospital between January 2013 to June 2015. The early complications including iridemia, intraocular pressure spike, iridocyclitis, corneal or lens injury and others after laser peripheral iridotomy were analyzed and followed up for 3mo.

RESULTS:Totally 274 females(416 eyes)and 88 males(96 eyes)were involved in the study. Among the 512 eyes identified, 248 eyes had primary angle closure glaucoma(PACG), 108 eyes had primary angle closure(PAC), 72 eyes had primary angle closure suspect(PACS), 66 eyes had no signs or symptoms(the fellow eye of PACG), and 18 eyes had secondary glaucoma or ocular hypertension with pupillary block. After LPI, 107 eyes(20.9%)had iridemia, 85 eyes(16.6%)had intraocular pressure spike, 14 eyes(2.7%)had iridocyclitis, 10 eyes(2%)had corneal injury, 2 eyes(0.4%)had lens injury, 1 eye(0.2%)had decompression retinopathy, and 2 eyes(0.4%)had exudative retinal detachment. The incidence of iridemia was highest among patients with acute PACG(33.7%, P=0.019), and the incidence of intraocular pressure spike was highest among patients with chronic PACG(23.0%, P=0.047).

CONCLUSION: The most common complications of Nd:YAG LPI include iridemia and intraocular pressure spike. Whether PACG patients are more likely to have these complications needs further study. Rare serious complications like decompression retinopathy and exudative retinal detachment should be considered. The indications and timing of LPI should also be chosen carefully according to the patient's specific condition.