目的：观察Nd：YAG激光周边虹膜切开术(LPI)治疗药物难控制性原发性闭角型青光眼(PACG)急性发作期患者的疗效。

方法：采用前瞻性研究，纳入襄阳市第一人民医院眼科2019-05/2020-06收治的药物难控制性PACG急性发作期患者20例22眼，所有受试对象均行LPI治疗，术前和术后检查患者视力、眼压、房角关闭范围、前房角角度(ACA)、前房容积(ACV)、中央前房深度(CACD)、周边前房深度(PACD)以及并发症。

结果：受试对象均可实施LPI。术前房角关闭范围均>180°，术后房角关闭范围≤180°有9眼(41%)； 21眼(95%)术后眼压与术前相比明显降低(P<0.05)； 术后前房参数除CACD无明显变化(P>0.05)，ACA、ACV、PACD均较术前增加(P<0.05)。术中15眼(68%)发生虹膜小瀑布样或丝样出血，5眼(23%)出现角膜上皮层损伤。

结论：LPI在药物难控制性PACG急性发作期可以实施，安全性高，能有效降低眼压，缓解症状，疗效显著。

METHODS: A prospective study was conducted on 22 eyes of 20 patients with drug-refractory primary angle-closure glaucoma treated in the Department of Ophthalmology of Xiangyang No.1 People's Hospital from May 2019 to June 2020. All subjects underwent Nd:YAG LPI. Visual acuity, intraocular pressure, chamber angle closure range, anterior chamber angle(ACA), anterior chamber volume(ACV), central anterior chamber depth(CACD)and peripheral anterior chamber depth(PACD)were measured before and after the operation. And observe the complications of LPI.

RESULTS:All patients can implement LPI. All subjects' chamber angle closure range were >180° before LPI and 9 eyes(41%)were ≤180° after LPI. The intraocular pressure of 21 eyes(95%)had significantly lower than postoperative(P<0.05). Postoperative anterior chamber parameters such as ACA, ACV and PACD were increased(P<0.05). During the operation,15 eyes(68%)had iris cascade or silk hemorrhage and 5 eyes(23%)had corneal epithelial damage.

CONCLUSION: LPI has high safety and can be implemented in the acute attack stage of drug-uncontrollable PACG. It can reduce intraocular pressure effectively and relieve symptoms, which has a significant effect in the patients.