激光虹膜切开与周边虹膜切除术治疗瞳孔闭锁继发青光眼的临床观察

目的 观察Nd:YAG激光虹膜切开术(LI)与虹膜周边切除术(PI)治疗瞳孔闭锁继发青光眼的临床疗效.方法 选取因葡萄膜炎引起瞳孔闭锁继发青光眼患者62例67只服,随机分为LI组和PI组.观察手术前后眼压、前房深度、炎症及虹膜切口通畅情况并进行统计学处理.平均随访时间(21.5±4.6)个月.结果 (1)LI组33只眼均能一次性击穿虹膜,前房深度由术前(0.67±0.31)mm加深为(2.58±0.26)mm,前后比较差异具有统计学意义.术后24h眼压南术前(28.22±7.12)mmHg降至(20.06±3.59)mmHg,前后比较差异具有统计学意义.术后26只眼(78.8%)发生激光孔闭合,未行再次激光治疗,22只眼行PI,4只眼行滤过手术.(2)PI组34只眼均形成通畅的周切口,术后结膜充血、前房炎症反应明显减轻.前房深度由术前(0.71±0.48)mm加深为(2.61±0.33)mm,前后比较差异具有统计学意义.眼压由术前(27.54±6.69)mmHg降至最未次随访(15.79±3.67)mmHg,前后比较差异具有非常统计学意义,手术成功率79.4%.结论 PI不仅能有效解除瞳孔闭锁、控制眼乐,而且有利于控制炎症、缩短疗程.

The curative effect of laser iridotomy and peripheral iridectomy in glaucoma secondary to seclusion of pupil

Objective To observe the curative effect of Nd:YAG laser iridotomy and peripheral iri-dectomy in glaucoma secondary to seclusion of pupil.Methods Sixty-seven eyes of 62 patients with glaucoma and seclusion of pupil secondary to uveitis were treated by Nd:YAG laser iridotomy or peripheral iddectomy ramdomly.We observed the changes in IOP、anterior chamber depth(ACD)、inflammation and incision of the Smooth case of iris pre-and post-operatively.The mean follow up time was(21.5±4.6)months.Results(1) Thirty thr eyes received one-time breakdown in iris after the initial treatment with laser peripheral iridotomy. The ACD deepened from(0.67±0.31)mm to(2.58±0.26)mm, and the IOP dropped from(28.22±7.12) mmHg to(20.06±3.59)mmHg after the operation.The statistical significance was obviously.But iris holes of 26 eyes were closed later.(2)Thirty four eyes formed easy and smooth holes in iris with peripheral iridectomy.The operationlead to lighten the conjunctival congestion and the inflammatory reaction of anterior chamber.The ACD from(0.71±0.48)mm to(2.61±0.33)mm,and the IOP dropped from(27.54±6.69)mmHg to(15.79±3.67)mmHg after the operation.The statistical significance was obviously.The successr rate of surgery was 79.4 per cent.Conclusion The curative effect of Nd:YAG laser iridotomy in glaucoma secondary to seclusion of pupil was not satisfaction.While the peripheral iridectomy not only cured the seclusion of pupil and controlled the IOP,but also controlled the inflammation and shortened the course of treatment.Early implamantion of pre-ventive treatment in those patients are beneficial.