中华眼外伤职业眼病杂志
中華眼外傷職業眼病雜誌
중화안외상직업안병잡지
CHINESE JOURNAL OF OCULAR TRAUMA AND OCCUPATIONAL EYE DISEASE
2012年
5期
383-386
,共4页
青光眼,闭角型%虹膜成形术,激光%眼压
青光眼,閉角型%虹膜成形術,激光%眼壓
청광안,폐각형%홍막성형술,격광%안압
Glaucoma,angle closure%Iridoplasty,laser%Intraoculax pressure
目的 观察手术前急性闭角型青光眼持续高眼压的情况下,先做激光虹膜成形术的有效性及安全性.方法 回顾分析急性闭角型青光眼急性发作期23例(23眼),最大剂量药物治疗后持续高眼压超过48 h,首先行激光虹膜成形术,眼压、炎症有效控制后,20眼行复合式小梁切除术(可调整缝线+术中丝裂霉素C),3眼行白内障超声乳化吸出及人工晶状体植入术.结果 激光虹膜成形术前眼压43 ～82mm Hg,平均(66.23±10.40)mm Hg,治疗后眼压12 ～28 mm Hg,平均(19.59±3.89)mm Hg(t =21.503,P=0.000).小梁切除或白内障手术后3个月19眼眼压8～20 mm Hg,平均(15.24±2.76)mm Hg,治愈率82.61％.4眼眼压21 ～27 mm Hg,有效率17.39％.所有患者视力有不同程度提高.结论 激光虹膜成形术可以有效降低急性闭角型青光眼持续高眼压患者的眼压,控制炎症,将高风险手术转变为常规手术,二期行青光眼滤过术或白内障超声乳化吸出术成功率高,并发症少.
目的 觀察手術前急性閉角型青光眼持續高眼壓的情況下,先做激光虹膜成形術的有效性及安全性.方法 迴顧分析急性閉角型青光眼急性髮作期23例(23眼),最大劑量藥物治療後持續高眼壓超過48 h,首先行激光虹膜成形術,眼壓、炎癥有效控製後,20眼行複閤式小樑切除術(可調整縫線+術中絲裂黴素C),3眼行白內障超聲乳化吸齣及人工晶狀體植入術.結果 激光虹膜成形術前眼壓43 ～82mm Hg,平均(66.23±10.40)mm Hg,治療後眼壓12 ～28 mm Hg,平均(19.59±3.89)mm Hg(t =21.503,P=0.000).小樑切除或白內障手術後3箇月19眼眼壓8～20 mm Hg,平均(15.24±2.76)mm Hg,治愈率82.61％.4眼眼壓21 ～27 mm Hg,有效率17.39％.所有患者視力有不同程度提高.結論 激光虹膜成形術可以有效降低急性閉角型青光眼持續高眼壓患者的眼壓,控製炎癥,將高風險手術轉變為常規手術,二期行青光眼濾過術或白內障超聲乳化吸齣術成功率高,併髮癥少.
목적 관찰수술전급성폐각형청광안지속고안압적정황하,선주격광홍막성형술적유효성급안전성.방법 회고분석급성폐각형청광안급성발작기23례(23안),최대제량약물치료후지속고안압초과48 h,수선행격광홍막성형술,안압、염증유효공제후,20안행복합식소량절제술(가조정봉선+술중사렬매소C),3안행백내장초성유화흡출급인공정상체식입술.결과 격광홍막성형술전안압43 ～82mm Hg,평균(66.23±10.40)mm Hg,치료후안압12 ～28 mm Hg,평균(19.59±3.89)mm Hg(t =21.503,P=0.000).소량절제혹백내장수술후3개월19안안압8～20 mm Hg,평균(15.24±2.76)mm Hg,치유솔82.61％.4안안압21 ～27 mm Hg,유효솔17.39％.소유환자시력유불동정도제고.결론 격광홍막성형술가이유효강저급성폐각형청광안지속고안압환자적안압,공제염증,장고풍험수술전변위상규수술,이기행청광안려과술혹백내장초성유화흡출술성공솔고,병발증소.
Objective To observe the efficacy and safety of laser iridoplasty for sustained high intraocular pressure in acute angle closure glaucoma before surgery.Methods 23 eyes in 23 patients during acute attack of acute angle closure glaucoma were analyzed retrospectively.All the patients had sustained high intraocular pressure (IOP) more than 48 hours after the medical treatment of maximal dose.They underwent laser iridoplasty first and after the IOP and inflanmation were effectively controlled,20 patients underwent trabeculectomy with adjustable suture and Mitomycin C during the surgery.Three patients underwent phacoemulsification and intraocular lens (IOL) implantation.Results IOP before laser iridoplasty were 43-82 mm Hg,average (66.23 ±:10.40) mm Hg.IOP after laser iridoplasty were 12 -28 nn Hg,average (19.59 ± 3.89) mm Hg(t =21.503,P =0.000 ).After 3 months of operation,IOP in 19 eyes were 8- 20 mm Hg,average ( 15.24 ±2.76) nun Hg,cure rate was 82.6％,IOP in 4 eyes were 21 -27 nn Hg,effeetive rate was 17.39％.Visual acuity increased to varying degrees in all patients.Conclusion Laser iridoplasty can reduce IOP and inhibit inflammation in acute angle closure glaucoma with sustained high IOP,transform the high risk surgery into the conventional surgery.Glaucoma filtration and phacoemulsification in the second stage had higher success rate and less complications.
