中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2012年
6期
738-741
,共4页
周炜%梁日雄%黄焕光%郑洁%陈素梅
週煒%樑日雄%黃煥光%鄭潔%陳素梅
주위%량일웅%황환광%정길%진소매
闭角型青光眼%选择性激光小梁成形术%激光周边虹膜成形术
閉角型青光眼%選擇性激光小樑成形術%激光週邊虹膜成形術
폐각형청광안%선택성격광소량성형술%격광주변홍막성형술
Angle-closure glaucoma%Selective laser trabeculoplasty%Laser peripheral iridoplasty
目的 评价选择性激光小梁成形(SLT)联合激光周边虹膜成形术(LPI)治疗闭角型青光眼的疗效及安全性.方法 对31例42只原发闭角型青光眼,经LPI治疗前房角被开放.术前平均眼压(24.44±3.26) mm Hg,日均用药指数(1.77±0.85)分.所有眼前房角能看到小梁网的范围约180度.用Q开关倍频Nd:YAG激光机在患眼开放的前房角照射小梁网.在180°范围内照射70～80点.术后继续使用术前的降眼压药物,定期复查眼压、视力、眼前节、前房角镜检查和房水流畅系数测定.结果 42只眼术后l、7天、l、3、6、9、12月的平均眼压分别为(17.23±3.06) mm Hg、(18.15±3.15) mm Hg、(19.82±3.22) mm Hg、(19.56±2.98) mm Hg、(19.01±3.14) mm Hg、(20.38±2.94) mm Hg、(20.77±3.27) mm Hg.与术前相比,术后1／12月眼压有显著下降(P＜0.Ol),用药指数差异无统计学意义(P＞0.05).术后即现睫状充血和前房闪辉,不用抗炎眼液l周自然消退.29眼术前和术后3月的房水流畅系数均值分别为0.13±0.09和0.36±0.14,差异有统计学意义(P =0.001).结论 SLT联合LPI能够安全有效降低部分闭角青光患者的眼压,但其前提是必须有1/2周的虹膜小梁角是被开放的.
目的 評價選擇性激光小樑成形(SLT)聯閤激光週邊虹膜成形術(LPI)治療閉角型青光眼的療效及安全性.方法 對31例42隻原髮閉角型青光眼,經LPI治療前房角被開放.術前平均眼壓(24.44±3.26) mm Hg,日均用藥指數(1.77±0.85)分.所有眼前房角能看到小樑網的範圍約180度.用Q開關倍頻Nd:YAG激光機在患眼開放的前房角照射小樑網.在180°範圍內照射70～80點.術後繼續使用術前的降眼壓藥物,定期複查眼壓、視力、眼前節、前房角鏡檢查和房水流暢繫數測定.結果 42隻眼術後l、7天、l、3、6、9、12月的平均眼壓分彆為(17.23±3.06) mm Hg、(18.15±3.15) mm Hg、(19.82±3.22) mm Hg、(19.56±2.98) mm Hg、(19.01±3.14) mm Hg、(20.38±2.94) mm Hg、(20.77±3.27) mm Hg.與術前相比,術後1／12月眼壓有顯著下降(P＜0.Ol),用藥指數差異無統計學意義(P＞0.05).術後即現睫狀充血和前房閃輝,不用抗炎眼液l週自然消退.29眼術前和術後3月的房水流暢繫數均值分彆為0.13±0.09和0.36±0.14,差異有統計學意義(P =0.001).結論 SLT聯閤LPI能夠安全有效降低部分閉角青光患者的眼壓,但其前提是必鬚有1/2週的虹膜小樑角是被開放的.
목적 평개선택성격광소량성형(SLT)연합격광주변홍막성형술(LPI)치료폐각형청광안적료효급안전성.방법 대31례42지원발폐각형청광안,경LPI치료전방각피개방.술전평균안압(24.44±3.26) mm Hg,일균용약지수(1.77±0.85)분.소유안전방각능간도소량망적범위약180도.용Q개관배빈Nd:YAG격광궤재환안개방적전방각조사소량망.재180°범위내조사70～80점.술후계속사용술전적강안압약물,정기복사안압、시력、안전절、전방각경검사화방수류창계수측정.결과 42지안술후l、7천、l、3、6、9、12월적평균안압분별위(17.23±3.06) mm Hg、(18.15±3.15) mm Hg、(19.82±3.22) mm Hg、(19.56±2.98) mm Hg、(19.01±3.14) mm Hg、(20.38±2.94) mm Hg、(20.77±3.27) mm Hg.여술전상비,술후1／12월안압유현저하강(P＜0.Ol),용약지수차이무통계학의의(P＞0.05).술후즉현첩상충혈화전방섬휘,불용항염안액l주자연소퇴.29안술전화술후3월적방수류창계수균치분별위0.13±0.09화0.36±0.14,차이유통계학의의(P =0.001).결론 SLT연합LPI능구안전유효강저부분폐각청광환자적안압,단기전제시필수유1/2주적홍막소량각시피개방적.
Objective To investigate the safety and efficacy of selective laser trabeculoplasty combined with laser peripheral iridoplasty for primary angle-closure glaucoma.Methods Forty-two eyes of 31 patients with angle-closure glaucoma of 180° angle opened were enrolled in this study.The average preoperative intraocular pressure (IOP) and number of medications (NM) were (24.44±3.26) mmHg and (1.77±0.85),respectively.The trabecular meshwork (TM) of each eye can be observed about 180°,which was irradiated with a frequency doubled Q-switched Nd:YAG laser.Total of 70-80 laser spots were placed over 180° of the TM.Topical antiglaucoma drugs were given as the same as preoperative during the follow up period.Visual acuity,IOP,slit lamp examination,gonioseopy,and coefficient of outflow facility were regularly performed after laser surgery.Results At the end of 1 day,1 week,and 1,3,6,9,12 months of follow-up period,IOP of 42 eyes were 17.23±3.06 mmHg,18.15±3.15mmHg,19.82±3.22 mmHg,19.56±2.98 mmHg,19.01±3.14 mmHg,20.38±2.94mmHg,20.77±3.27 mmHg,respectively.Compared with baseline,there were statistically significant lOP decrease (P ＜ 0.01),and without obviously decrease of NM (P ＞ 0.05),during 1-12months postoperatively.Ciliary congestion and aqueous flare were disappearance without anti-inflammatory eye drops 1 week later.Coefficient of outflow facility were 0.13±0.09 和0.36±0.14 respectively at pretreatment and 3 months after SLT,difference was statistically significant (P =0.001).Conclusions Selective laser trabeculoplasty combined with laser peripheral iridoplasty for primary angle-closure glaucoma is effective and safe for angle-closure glaucoma,however,it is an essential prerequisite that 1/2 circle of angle of the anterior chamber is opened.
