NA:YAG激光虹膜切除术治疗闭角型青光眼201例临床观察

目的评价NA：YAG激光虹膜切除术治疗原发性闭角型青光眼和葡萄膜炎继发青光眼的临床疗效。方法回顾分析192例219眼原发性闭角型青光眼和9例葡萄膜炎继发青光眼，接受NA：YAG激光虹膜切除术后的临床效果，随诊16—46月。结果激光切孔一次成功205眼（占89e），激光能量在11—17．1mJ，67％病例在22—84Mj，击射次数2-33次。葡萄膜炎继发青光眼9眼均二次激光后虹膜孔通畅。95．61％术后眼压正常，视野无变化，术后早期一过性眼压升高占34％，术中出血占36％，房角色素增加占47％，1例术后28月接受小量切除术，8例术后需配合使用降眼压药物控制眼压。结论NA：YAG激光虹膜切除术是一种治疗闭角型青光眼的安全有效的方法。术前掌握适应症，把握手术时机，充分的术前准备是手术成功的关键。

The clinical observation on NA:YAG laser Iridectomy for 201 angle-closure glaucoma

Objective: To evaluate the clinical efficacy of Nd:YAG laser iridectomy for primary angle-closure glaucoma and angle-closure glaucoma secondary to uveitis.Methods: 219 eyes of 192 patients with primary angle-closure glaucoma and 9 cases with angle-closure glaucoma secondary to uveitis were treated by NA: YAG laser iridectomy,and the clinical effects were then retrospectively analyzed.All cases were followed up for 16~46 months.Results: 205 eyes(89%) got patent holes in iris after the initial treatment.The laser energy ranged from 11 to 171mJ in which 67% cases were at 22~84MJ and the number of burns ranged from 2 to 33.9 cases secondary to uveitis all got patent holes after the second treatment.The intraocular pressure was controlled well in 95.61% of all eyes and the eyeshot was not changed.The increase of intraocular pressure appeared in 34% of patients in the early part.36% of patients have hemorrhage symptoms in surgery and 47% of patients have the raise of pigment granule in angle.One patient had to undergo the traditional trabeculectomy after 28 months.Eight patients have to use drugs to manage the intraocular pressure.Conclusion: NA :YAG laser iridectomy is the effective and safe method for angle-closure glaucoma.Understanding the surgical indication,finding out the time of surgery and making the excellent preparation are the pivotal factors for the successful surgery.