CAJ | 학술논문

目的：研究激光周边虹膜成形术（ LPI）对急性发作期闭角型青光眼角膜内皮细胞的影响。方法回顾性系列病例研究。对2005年9月至2007年9月确诊的原发性闭角型青光眼急性发作期患者180例（180只眼）分为药物组及治疗组，药物组应用降眼压药物联合LPI，治疗组及时行LPI边虹膜成形术，术后1～2 d、1个月观察患者角膜内皮细胞情况。采用配对t检验的方法分别比较药物组和治疗组术后1～2d和术后1个月发作眼和对侧眼角膜内皮细胞密度差异采用配对t检验；药物组与治疗组治疗1个月后，发作眼角膜内皮细胞密度的比较采用t检验。结果治疗后1～2 d：药物组发作眼角膜内皮细胞密度为（2406．30±586．45）个/mm2，对侧眼角膜内皮细胞密度为（2623．49±446．01）个/mm2，差异有统计学意义（t＝-2．223，P＜0．05）；治疗组发作眼角膜内皮细胞密度为（2461．33±636．82）个/mm2，对侧眼角膜内皮细胞密度为（2553．88±515．22）个/mm2，差异无统计学意义（t＝-1．059，P＞0．05）；治疗后1个月：药物组发作眼角膜内皮细胞密度为（2450．93±639．27）个/mm2，对侧眼角膜内皮细胞密度为（2621．13±469．43）个/mm2，差异无统计学意义（t＝-1．778，P＞0．05）；治疗组发作眼角膜内皮细胞密度为（2401．34±617．76）个/mm2，对侧眼角膜内皮细胞密度为（2613．66±460．61）个/mm2，差异有统计学意义（t＝-2．822，P＜0．05）；治疗1个月时药物组与治疗组发作眼角膜内皮细胞密度与眼压下降后1～2d时的发作眼角膜内皮细胞密度变化比较，药物组角膜内皮细胞密度减少（43±412．55）个/mm2，治疗组角膜内皮细胞密度减少（80．96±537．09）个/mm2，差异无统计学意义（t＝-0．533，P＞0．05）。结论 LPI对角膜内皮细胞的无明显损害，是闭角型青光眼急性发作期的安全治疗方法之一。目的：研究激光週邊虹膜成形術（ LPI）對急性髮作期閉角型青光眼角膜內皮細胞的影響。方法迴顧性繫列病例研究。對2005年9月至2007年9月確診的原髮性閉角型青光眼急性髮作期患者180例（180隻眼）分為藥物組及治療組，藥物組應用降眼壓藥物聯閤LPI，治療組及時行LPI邊虹膜成形術，術後1～2 d、1箇月觀察患者角膜內皮細胞情況。採用配對t檢驗的方法分彆比較藥物組和治療組術後1～2d和術後1箇月髮作眼和對側眼角膜內皮細胞密度差異採用配對t檢驗；藥物組與治療組治療1箇月後，髮作眼角膜內皮細胞密度的比較採用t檢驗。結果治療後1～2 d：藥物組髮作眼角膜內皮細胞密度為（2406．30±586．45）箇/mm2，對側眼角膜內皮細胞密度為（2623．49±446．01）箇/mm2，差異有統計學意義（t＝-2．223，P＜0．05）；治療組髮作眼角膜內皮細胞密度為（2461．33±636．82）箇/mm2，對側眼角膜內皮細胞密度為（2553．88±515．22）箇/mm2，差異無統計學意義（t＝-1．059，P＞0．05）；治療後1箇月：藥物組髮作眼角膜內皮細胞密度為（2450．93±639．27）箇/mm2，對側眼角膜內皮細胞密度為（2621．13±469．43）箇/mm2，差異無統計學意義（t＝-1．778，P＞0．05）；治療組髮作眼角膜內皮細胞密度為（2401．34±617．76）箇/mm2，對側眼角膜內皮細胞密度為（2613．66±460．61）箇/mm2，差異有統計學意義（t＝-2．822，P＜0．05）；治療1箇月時藥物組與治療組髮作眼角膜內皮細胞密度與眼壓下降後1～2d時的髮作眼角膜內皮細胞密度變化比較，藥物組角膜內皮細胞密度減少（43±412．55）箇/mm2，治療組角膜內皮細胞密度減少（80．96±537．09）箇/mm2，差異無統計學意義（t＝-0．533，P＞0．05）。結論 LPI對角膜內皮細胞的無明顯損害，是閉角型青光眼急性髮作期的安全治療方法之一。
목적：연구격광주변홍막성형술（ LPI）대급성발작기폐각형청광안각막내피세포적영향。방법회고성계렬병례연구。대2005년9월지2007년9월학진적원발성폐각형청광안급성발작기환자180례（180지안）분위약물조급치료조，약물조응용강안압약물연합LPI，치료조급시행LPI변홍막성형술，술후1～2 d、1개월관찰환자각막내피세포정황。채용배대t검험적방법분별비교약물조화치료조술후1～2d화술후1개월발작안화대측안각막내피세포밀도차이채용배대t검험；약물조여치료조치료1개월후，발작안각막내피세포밀도적비교채용t검험。결과치료후1～2 d：약물조발작안각막내피세포밀도위（2406．30±586．45）개/mm2，대측안각막내피세포밀도위（2623．49±446．01）개/mm2，차이유통계학의의（t＝-2．223，P＜0．05）；치료조발작안각막내피세포밀도위（2461．33±636．82）개/mm2，대측안각막내피세포밀도위（2553．88±515．22）개/mm2，차이무통계학의의（t＝-1．059，P＞0．05）；치료후1개월：약물조발작안각막내피세포밀도위（2450．93±639．27）개/mm2，대측안각막내피세포밀도위（2621．13±469．43）개/mm2，차이무통계학의의（t＝-1．778，P＞0．05）；치료조발작안각막내피세포밀도위（2401．34±617．76）개/mm2，대측안각막내피세포밀도위（2613．66±460．61）개/mm2，차이유통계학의의（t＝-2．822，P＜0．05）；치료1개월시약물조여치료조발작안각막내피세포밀도여안압하강후1～2d시적발작안각막내피세포밀도변화비교，약물조각막내피세포밀도감소（43±412．55）개/mm2，치료조각막내피세포밀도감소（80．96±537．09）개/mm2，차이무통계학의의（t＝-0．533，P＞0．05）。결론 LPI대각막내피세포적무명현손해，시폐각형청광안급성발작기적안전치료방법지일。
Objective To study effects of laser peripheral iridoplasty( LPI) on corneal endothelial cells of acute attack of primary angle-closure glaucoma ( PACG).Methods Retrospective study of 180 patients (180 eyes) acute attack of primary angle-closure glaucoma that were diagnosed from 09, 2005 to 09, 2007 were devided into two groups.The drop group was therapied hypotensive drugs combined.The therapy group was therapied by laser peripheral iridoplasty.Corneal endothelial cells were observed at postoperative 1-2 days, 1 month.The method using a paired t-test were compared medication and treatment groups after 1 to 2 days and one month, onset eye and the contralateral eye corneal endothelial cell density and whether the differences were statistically significant.Drop group and the treatment group a month after the onset eye corneal endothelial cell density compared using the t-test approach.Restults 1-2 days after treatment:drug group onset eye corneal endothelial cell density (2406.30±586.45) a/mm2, contralateral eye corneal endothelial cell density (2623.49±446.01)a/mm2, There were significant difference between their (t=-2.223, P<0.05).Therapy group onset eye corneal endothelial cell density (2461.33 ± 636.82)a/mm2, contralateral eye corneal endothelial cell density (2553.88 ±515.22) a/mm2, no statistically significant difference between their (t=-1.059, P>0.05);1 month after treatment:drug group onset eye corneal endothelial cell density (2450.93±639.27)a/mm2, contralateral eye corneal endothelial cell density (2621.13±469.43)a/mm2, no statistically significant difference between the two (t=-1.778, P>0.05); Treatment group onset eye corneal endothelial cell density (2401.34 ±617.76)a/mm2, contralateral eye corneal endothelial cell density (2613.66±460.61)a/mm2, there was significant difference between the two(t=-2.822, P<0.05);1 month of treatment, drug and therapy groups onset eye corneal endothelial cell density and decrease in IOP after 1-2 days, the onset eye of corneal endothelial cell density compared, Drug group corneal endothelial cell density decreased ( 43 ±412.55) a/mm2 , therapy group corneal endothelial cell density decreased (80.96±537.09)a/mm2, the differences between the two groups was not statistically significant (t=-0.533, P>0.05).Conclusion Laser peripheral iridoplasty was without obvious injuries of corneal endothelial cells for acute attack of PACG and it was a safe approach for acute attack of PACG.