作者：李宪华，郑蕊，冯一韦
作者单位：(100076)中国北京市大兴区红星医院眼科
【摘要】目的: YAG激光周边虹膜切除术治疗闭角型青光眼的疗效及并发症的临床观察。
方法:本组病例20例（25眼)，诊断为闭角型青光眼临床前期、前驱期的22眼，3眼为间歇期。使用Nd：YAG激光机在虹膜中周部单脉冲击射均为一次透切成功，随访3～12mo，观察疗效及并发症。
结果:25眼激光切孔1次手术成功率100%。术后均出现了虹膜炎性反应，1～3h内一过性眼压升高5眼，前房出血4眼，角膜内皮损伤1眼，全部并发症于术后1～3d消失。无切孔后晶状体混浊及孔洞闭塞并发症发生。术后周边前房及房角增宽，眼压<18mmHg。
结论:Nd：YAG激光周边虹膜切除术治疗闭角型青光眼安全有效，对早期患者效果更佳，适宜在基层医院推广。
【关键词】 激光 虹膜周边切除 闭角型青光眼
Clinical observation on laser peripheral iridectomy treatment for early stage angleclosure glaucoma
XianHua Li, Rui Zheng, YiWei Feng
Department of Ophthalmology, Beijing Daxing District Hongxing Hospital, Beijing 100076, China
Abstract
AIM: Clinical observation on laser pheripheral iridectomy treatment for angleclosure glaucoma and the complications.
METHODS: Twenty patients (25 eyes) were diagnosed by angleclosure glaucoma, of them, 22 eyes was at early clinical stage and 3 eyes at intermittent stage. Nd: YAG laser singe pulse launch was performed on the middle of iris periphery. Followingup time was for 312 months, and the clinical effect and complications were observed.
RESULTS: All 25 eyes was finished in one time (success rate 100%). Iris inflammation reaction was found in all the patients after operation, in which 5 eyes rose the intraocular pressure (IOP) within 13 hours, 4 eyes were presented anterior chamber bleeding, and 1 eye had epithelial damage in the cornea. All the complications disappeared within 13 days. The complications such as crystalline turbid, hole obstruction were not found. Peripheral anterior chamber and chamber anger were got wide and IOP<18mmHg.
CONCLUSION: Nd: YAG laser peripheral iridectomy is a safe and effective method to treat angleclosure glaucoma, especially for the patients at early stage. It is suitable for primary hospitals.
KEYWORDS: laser; peripheral iridectomy; angleclosure glaucoma
0引言
青光眼是我国目前主要致盲性眼病之一，在盲人群中调查，其中20%为青光眼所致，失明后不能复明。我国闭角型青光眼占青光眼病例的79.60%～86.13%[1]，以老年人发病居多。随着社会逐渐进入老龄化，闭角型青光眼会进一步增多，而且病情复杂，提高青光眼治愈率，降低治盲率，是眼科医生研究和努力的目标。随着科学技术和设备仪器的发展，青光眼的治疗也有了新的飞跃。激光虹膜周边切除术在治疗瞳孔阻滞型闭角型青光眼有着很好的疗效。我院200701/200806用Nd:YAG激光机治疗早期闭角型青光眼，取得了明显的效果，现总结报告如下。
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