虹膜周边前后节沟通术在恶性青光眼患者治疗中的应用

目的　评价虹膜周边前后节沟通术治疗恶性青光眼及具有恶性青光眼倾向的原发性闭角型青光眼患者的临床效果。方法　收集我院2013年5月至2018年4月行虹膜周边前后节沟通术的88例（92眼）恶性青光眼及具有恶性青光眼倾向的原发性闭角型青光眼患者资料。观察手术前后眼压、最佳矫正视力、中央及周边前房深度及房角的变化情况，术后随访（25.7±13.5）个月。结果　恶性青光眼患者术前药物控制下眼压（34.27±12.95）mmHg（1 kPa=7.5 mmHg），术后第7天及末次随访眼压分别为（12.94±3.12）mmHg、（13.17±4.54）mmHg，与术前相比，差异均有统计学意义（均为P＜0.01）。末次随访最佳矫正视力较术前明显提高（P＜0.05）。有恶性青光眼倾向的原发性闭角型青光眼患者术前患眼药物控制下眼压 （20.50±7.41）mmHg，术后第7天及末次随访眼压分别为（13.92±4.39）mmHg、（15.25±4.54）mmHg，与术前相比，差异均有统计学意义（均为P＜0.01）。术后最佳矫正视力与术前相比差异无统计学意义（P＞0.05）。所有患者中央前房深度术前为 （1.67±0.33）mm，术后1个月为（3.35±0.35）mm，差异有统计学意义（P＜0.01）。患者术前周边前房深度均<1/2 CT，术后89眼周边前房深度≥1 CT。术前72眼房角关闭范围>180°，术后房角完全开放38眼。结论　虹膜周边前后节沟通术可有效治疗恶性青光眼及具有恶性青光眼倾向的原发性闭角型青光眼患者。     

激光周边虹膜成形术治疗残余性青光眼

目的评价倍频Nd:YAG激光行激光周边虹膜成形术治疗残余性青光眼的有效性。方法 20例22眼残余性青光眼,使用倍频Nd:YAG激光行激光周边虹膜成形术,观察术后眼压、视力、杯盘比、前房深度、房角角度等指标变化情况。结果术后1个月、3个月、6个月眼压分别为(18.48±1.60)mmHg(1kPa=7.5mmHg)、(18.72±1.40)mmHg、(19.21±1.49)mmHg,与术前相比,差异均有统计学意义(均为P<0.05);术后6个月时杯盘比为0.59±0.22,与术前相比,差异无统计学意义(P>0.05);术后6个月时前房深度为(1.72±0.22)mm,与术前相比,差异无统计学意义(P>0.05);术后6个月时房角角度为(21.41±2.74)°,与术前相比,差异有统计学意义(P<0.05)。结论倍频Nd:YAG激光行激光周边虹膜成形术能有效降低残余性青光眼患者的眼压,手术简单易行,值得临床推广。     

激光周边虹膜成形术治疗周边虹膜切除术后的原发性闭角型青光眼

目的 评价激光周边虹膜成形术(LPIP)治疗周边虹膜切除术后眼压失控原发性闭角型青光眼(PACG)的临床效果,进一步探寻原发性闭角型青光眼治疗新思路.方法 回顾性分析激光周边虹膜切开术(LPI)或周边虹膜切除术(SPI)后眼压失控PACG行LPIP治疗患者38例53只眼.观察手术前后眼压、视力、中央前房深度(ACD)、房角开放距离(AOD500)、前房角形态及并发症等.随访12～24月,平均(14.4±7.6)月.结果 术前眼压(24.3±4.2) mm Hg,LPIP术后最末次随访眼压(17.5±6.7) mm Hg,与术前比较平均下降(6.8±2.5)mm Hg,差异具有统计学意义(t=4.15,P＜0.05).ACD:术前(1.97±0.41)mm,LPIP术后1月、6 月、12月分别为(2.01±0.54)mm、(1.99±0.63)mm、(2.05±0.77) mm,与术前比较差异无统计学意义(F=2.90,P=0.08).AOD500:术前(155.3±54.8) μm,LPIP术后1月、6月、12月分别为(259.7±71.3)μm、(263.3±61.5)μm、(264.7±35.8)μm,术后均较术前加深,差异具有统计学意义(F=67.5,P=0.000).术后前房角结构可见范围增加,周边虹膜前粘连范围缩小.术后早期视力无变化,随访时间内视野损害无进展.主要并发症是瞳孔轻度散大.结论 LPIP治疗LPI或SPI术后眼压失控PACG,能明显加深前房角开放距离,有效解除非瞳孔阻滞发病因素,控制眼内压,阻止病情进展.PACG发病因素多种复杂,其治疗不能单纯依据前房角关闭范围采取单一手术,应采取具有针对性个性化治疗方案.     

超声乳化白内障吸出和IOL植入术治疗激光周边虹膜切除术后急性闭角型青光眼(英文)

目的:观察超声乳化白内障吸出术联合人工晶状体(IOL)植入治疗激光周边虹膜切除术后闭角型青光眼的治疗效果。方法:激光周边虹膜切除术后闭角型青光眼并白内障患者39例(39眼),被分为两组,Ⅰ组须用抗青光眼药控制眼压,Ⅱ组不须用抗青光眼药控制眼压,患者均行超声乳化白内障吸出和折叠式人工晶状体植入术,术后随访3mo。结果:两组术后最佳矫正视力均较术前显著提高(P<0.05)。术后3moⅠ组眼压为15.72±3.02mmHg,Ⅱ组为16.30±3.81mmHg,两组眼压均比术前明显下降,有显著性差别(P<0.05)。Ⅰ组中央前房深度由术前1.64±0.45mm加深至术后3mo的3.21±0.41mm,Ⅱ组中央前房深度由术前1.92±0.52mm加深至术后3mo的3.18±0.39mm,两组术后中央前房深度均比术前明显加深,有显著性差异(P<0.05),前房角明显增宽。结论:超声乳化白内障吸出和人工晶状体(IOL)植入术不仅能提高激光周边虹膜切除术后青光眼视力,而且可彻底解除闭角型青光眼的瞳孔阻滞。     

联合激光虹膜切除术术后超声乳化晶状体摘出术治疗急性闭角型青光眼持续高眼压的疗效观察

目的探讨联合激光虹膜切除术后超声乳化晶状体摘出术治疗急性闭角型青光眼持续性高眼压的临床效果。方法选取2009年6月至2011年6月我院诊治的急性闭角型青光眼持续高眼压,并行联合激光虹膜切除术后超声乳化晶状体摘出+人工晶状体植入术患者48例(50眼),患者先行联合激光虹膜切除术,7～30d行超声乳化晶状体摘出+人工晶状体植入术;测量虹膜切除术前后眼压、晶状体摘出术后1周内眼压、4～6周眼压、随访6个月时的眼压,手术前后前房深度、房角关闭范围,术中、术后并发症。结果晶状体摘出术后核硬度为Ⅱ和Ⅲ级眼的眼压均低于术前眼压和虹膜切除术后的眼压,差异均有统计学意义(均为P<0.05)。中央前房深度由术前的(1.23±0.40)mm增加到虹膜切除术后(2.28±0.33)mm及晶状体摘出术后(3.32±0.38)mm,两两比较差异有显著统计学意义(P<0.01)。结论联合激光虹膜切除术后超声乳化晶状体摘出术可有效治疗急性闭角型青光眼持续高眼压,解除患者瞳孔阻滞,降低眼压。     

激光周边虹膜成形及切除术治疗药物难控制的急性闭角型青光眼

目的：探讨激光周边虹膜成形联合周边虹膜切除术,治疗药物难控制的急性闭角型青光眼的效果和安全性。方法：选取药物治疗24h后眼压仍高于21mmHg的原发性急性闭角型青光眼15例17眼和白内障膨胀期继发的急性闭角型青光眼4例4眼,共19例21眼,采用激光周边虹膜成形联合周边虹膜切除术,术后24h观察视力、眼压、角膜、周边前房深度、房角及并发症。结果：所有患者激光术后24h眼压均有大幅度的下降,术前眼压53.09±11.01mmHg,术后24h眼压下降至14.98±4.21mmHg,治疗前后差异有统计学意义（P〈0.01 ）。术后视力由术前手动～0.3提高至0.1～1.0。所有患者角膜水肿减轻或消退,周边前房深度增加,房角不同程度开放。其中虹膜出血11眼（52.4%）,轻度反应性虹膜炎21眼（100%）,无1眼发生角膜灼伤。结论：激光周边虹膜切除联合周边虹膜成形术,是降低药物难控制的急性闭角型青光眼眼压的一种安全有效的方法。     

超声生物显微镜评价联合激光治疗急性原发性闭角型青光眼

目的 观察激光周边虹膜成形术联合周边虹膜切除术在治疗初次发作的急性闭角型青光眼中的安全性和有效性.方法 初次发作的急性闭角型青光眼患者67例70眼,诊断后立即行氪激光周边虹膜成形术同时或待角膜透明后行YAG激光周边虹膜切除术,观察激光治疗前后视力、眼压及超声生物显微镜监测下的房角开放度数变化.结果 视力术后24 h 92.85%的患眼视力提高2行以上;眼压术前32～80 mmHg(1 kPa=7.5 mmHg),平均(42.5±18.5) mmHg,术后1 h平均眼压(27.5±9.5) mmHg,术后4 h平均眼压(20.2±6.7) mmHg;中央前房深度术前平均(1.69±0.34) mm,术后平均(2.13±0.20) mm;房角开放情况术前均1/2以上关闭,术后92.85%患眼(65/70)房角不同程度改善,以下方和颞侧增宽明显;平均房角开放度数术前平均2.15°±0.17°,术后6.23°±0.26°.激光术后各时间点眼压及术后超声生物显微镜下的房角开放度数、前房深度与术前比较差异均有统计学意义(P＜0.05).结论 氪激光周边虹膜成形术联合YAG激光周边虹膜切除术是急性闭角型青光眼早期快速降眼压的一种安全有效的方法.     

白内障青光眼联合手术中的虹膜周边切除术

目的探讨虹膜周边切除(PeripheralIridectomyPI)在白内障合并原发性闭角型青光眼(Primaryangle-closureglaucoma,PACG)联合手术中的必要性。方法连续无选择地将白内障青光眼联合手术中未行PI的患者30例36只眼,与既往联合手术中行PI的患者36例36只眼进行比较,观察视力、术后一周和三月的眼压,以及术中、术后并发症,并将数据进行统计学分析。结果两组术后视力均较术前有不同程度的提高;术后两组平均眼压明显下降,未行PI组为13.18mmHg,行PI组为13.34mmHg,术前眼压在未行PI组为(33.12±8.01)mmHg,行PI组为(32.74±6.57)mmHg,两组间差异无显著性意义(p>0.05);术后一周时眼压在未行PI组为(19.94±3.17)mmHg,行PI组为(19.40±2.48)mmHg,两组间差异无显著性意义(p>0.05);术后三月时眼压在未行PI组为(19.34±3.41)mmHg,行PI组为(19.12±2.81)mmHg,两组间差异无显著性意义(p>0.05);两组术中、术后并发症的发生率相同,均是5.6%。结论在白内障青光眼联合手术中,是否行PI对手术效果无明显影响。     

YAG激光虹膜周边切开术联合非穿透性小梁切除治疗闭角型青光眼

目的 观察YAG激光虹膜周边切开术联合非穿透性小梁切除术(NPDS)治疗单纯瞳孔阻滞型闭角型青光眼的疗效.方法 对2002年1月至2004年10月收治的21例(35只眼)单纯瞳孔阻滞型闭角型青光眼进行YAG激光虹膜周边切开术联合非穿透性小梁切除术,分析手术前后眼压的差异及术后各个随访期的手术成功率.随访期10～36月,平均(18.77±10.47)月.结果 术前平均眼压(25.57±4.92)mmHg,术后3月、6月、12月、24月和36月的眼压分别为(13.34±4.18)mmHg、(14.49±2.83)mmHg、(14.92±4.57)mmHg、(16.77±3.45)mmHg、(17.32±4.17)mmHg.术后3月、6月、12月、24月和36月的完全成功率分别为81.2%、78.1%、73.3%、69.0%、66.1%;部分成功率分别为82.4%、80.9%、74.7%、72.7%、70.1%.并发症有:微穿透6例,前房出血4例,低眼压3例,脉络膜脱离2例.结论 YAG激光虹膜周边切开术联合NPDS可作为治疗部分类犁的闭角型青光眼是安全有效地手术方式.     

改良激光虹膜成形术治疗慢性闭角型青光眼

目的 评估改良激光虹膜成形术治疗慢性闭角型青光眼的效果和安全性.方法 应用氪激光大光斑自虹膜中外1/3交界处开始向前房角方向依次进行放射状光凝,范围为360°周边虹膜.用此方法治疗慢性闭角型青光眼患者31例52眼.观察术后1 d、1周、1个月患者视力、眼压、角膜内皮细胞、前房角及术后并发症情况.结果 改良激光虹膜成形术术前平均眼压为(42.7±8.9)mmHg(1 kPa=7.5 mmHg);术后1 d、1周、1个月平均眼压分别为(15.3±8.2)mmHg、(14.4 ±11.1)mmHg、(14.8±13.2)mmHg,术后眼压与术前相比差异均有统计学意义(均为P<0.05).术后1 d、1周、1个月眼压≤21 mmHg者分别为45眼(86.5%)、43眼(82.7%)、41眼(78.8%).角膜内皮细胞平均密度术前为(2 683±248)mm-2,术后1周为(2 651±284)mm-2,术后1个月为(2 625±321)mm-2,术后1周、1个月与术前相比差异均无统计学意义(均为P>0.05).术后1 d、1周、1个月前房角累积开放范围>1/2周者分别为46眼(88.5%)、44眼(84.6%)、42眼(80.8%).术后所有患者均有不同程度的瞳孔变形(1周后减轻,1个月后有9眼未恢复)和虹膜炎症反应(用药3 d后减轻或消失).所有患者均无虹膜脱色素、出血、一过性眼压升高等并发症.结论 改良激光虹膜成形术治疗慢性闭角型青光眼可使关闭的前房角开放,眼压得到控制,且无明显角膜内皮细胞的损害.     

Nd:YAG激光虹膜切除术治疗葡萄膜炎继发闭角型青光眼

目的 评价Nd：YAG激光虹膜切除术治疗葡萄膜炎继发闭角型青光眼的临床效果。方法 回顾性分析27例葡萄膜炎继发瞳孔阻滞闭角型青光眼经Nd：YAG激光虹膜切除术治疗的情况。随诊时间2月到4年。结果1)一次激光所有患眼均成功击穿虹膜。虽经术后积极抗炎治疗．12眼(44％)发生虹膜孔关闭。多次激光治疗后，最终89％的患眼获得了通畅的激光孔。2)在46次激光治疗中，击射点数为3～376点，激光能量为12～2077mJ。所用激光能量较原发闭角型青光眼高。3)75％的患眼激光治疗后眼压控制正常，6只眼(22％)眼压不能控制行滤过手术。4)激光手术的并发症主要是激光时虹膜的出血和暂时的眼压升高。5)术前有活动性炎症的患眼，发生激光孔闭合的比例更高。结论 Nd：YAG激光虹膜切除术是治疗葡萄膜炎继发闭角型青光眼的一种安全有效的方法。为提高手术的成功率，应在积极抗炎的同时，尽早行激光虹膜切除术。若激光后虹膜孔反复关闭，应考虑手术周边虹膜切除术。     

Akutes Winkelblockglaukom trotz vorhandener Nd:YAG-Laser-Iridotomie

BACKGROUND: Nd:YAG laser iridotomy is routinely used as a procedure for primary acute angle-closure glaucoma (AACG). The clear advantage of Nd:YAG laser iridotomy is to resolve pupillary block without opening the eye. Nevertheless it remains unclear whether Nd:YAG laser iridotomy is equally effective as surgical iridectomy. In this context cases in which AACG recurred despite patent Nd:YAG laser iridotomy are of interest. PATIENTS AND METHODS: In a retrospective study, we analyzed the charts of 90 patients who presented with unilateral primary AACG in our department over 3 years and were treated with a surgical iridectomy. Surgical iridectomy at the 12 o'clock position was performed using a self-sealing corneal incision. RESULTS: Of the 90 patients with primary AACG, 13 (14.4%) had already been treated with Nd:YAG laser iridotomy. Despite the laser iridotomy, these eyes developed recurrent AACG. The presenting intraocular pressure (IOP) of these 13 eyes was 49.07+/-12.65 mmHg. In 4 eyes, continuous medical glaucoma therapy was used prior to AACG, 8 eyes showed signs of glaucoma damage at the optic disk or/and the visual field. In 2 eyes, the presenting high IOP at AACG could be lowered by medication. All other eyes were operated at high IOP. The average interval between the Nd:YAG laser iridotomy and the AACG was 24.5 weeks. After surgical iridectomy, the IOP was reduced to 12.69+/-4.11 mmHg and was 16.62+/-3.86 mmHg at the end of the observation period. CONCLUSIONS: In spite of Nd:YAG laser iridotomy recurrent AACG can occur. Surgical iridectomy is capable of permanently resolving the pupillar block in these cases.     

辰泽滴眼液在激光虹膜周切术中的应用

目的 评价辰泽滴眼液在激光虹膜周切术中的临床应用价值。方法 选择86例（172眼）双眼进行Nd：YAG激光虹膜周切术的患者,在激光治疗前1h滴2％毛果芸香碱滴眼液两次后,分为两组,一眼加滴辰泽滴眼液1滴,在激光手术完成后即刻再次滴入辰泽滴眼液一滴,另一眼不用辰泽滴眼液。术后1h测量双眼的眼压,第二天复诊时观察虹膜周切口的情况并再次测量眼压,术后一周复诊观察虹膜周切口的情况并再次测量眼压。如眼压升高大于22 mm Hg需进行降眼压治疗。结果 辰泽滴眼液能良好的控制行激光虹膜周切术后患者的眼压,仅有5只眼(5.81％)应用辰泽滴眼液患者的眼压略高于22 mm Hg,未予降眼压治疗;而未应用辰泽滴眼液的患眼眼压升高达48只眼(55.81％),术后1h眼压测量比较,所有应用辰泽滴眼液的术眼的眼压升高远较对侧眼为低,且辰泽滴眼液也能较好地改善滴用毛果芸香碱滴眼液后球结膜充血。结论 辰泽滴眼液在激光虹膜周切术中能明显减轻手术副反应,降眼压效果确切,建议临床中推广应用。     

A PRELIMINARY STUDY OF SHORT-TERM EFFICACY OF Nd:YAG LASER PERIPHERAL IRIDOTOMY IN PATIENTS WITH PRIMARY ANGLE CLOSED GLAUCOMA

Q-switched Nd:YAG laser was used for the peripheral iridotomy in 68 cases(80 eyes) of primary angle closed glaucoma. The average number of laser shots is 20.5(1～127 shots), and the average shot energy is 2.5 mJ(0.9～5.6mJ). The successful rate of iris penetration is about 97.6%. The size of the iris hole is not smaller than 0.2mm~2. The kind of the iris is the most important factor that causes the marked variation in laser shots and in laser shot energy. The main complications of Nd:YAG laser iridotomy p...     

Low-energy linear-incision neodymium: YAG laser iridotomy versus linear-incision argon laser iridotomy. A prospective clinical investigation

When the Q-switched neodymium: YAG (Nd: YAG) laser is focused through the Wise 103-diopter (D) iridotomy-sphincterotomy lens (103-D lens) at low energy levels, the peripheral iris fibers can be cut individually across the iris tension lines to produce large iridotomies of controllable size. Thirty patients had linear-incision Nd:YAG laser iridotomy in one eye and linear-incision argon laser iridotomy in the other. Two-hour post-laser IOP rises averaged 7.33 mmHg for the Nd:YAG laser and 8.64 mmHg for the argon laser. The argon laser produced lens burns in 9 of 30 eyes, including 7 of 9 blue eyes. No lens damage occurred with the Nd:YAG laser. No corneal or retinal damage was seen with either laser. Local oozing of blood inhibited optical breakdown and required a pause before completion in 5 of 30 eyes with Nd:YAG iridotomy, including 4 of 6 dark brown thick irides. Because the iris fibers must be cut by direct contact with the laser plasma, serial cutting of iris fibers by multiple low-energy plasmas is safer than a single-shot, high-power plasma occupying the full thickness of the iris. Because it is effective and because it avoids the hazards of argon laser iridotomy and of high-power Nd:YAG laser iridotomy, linear incision Nd:YAG laser iridotomy is recommended as the safest method of iridotomy.     

Creeping angle-closure glaucoma: The influence of iridotomy and iridectomy

In 16 patients (30 eyes) with creeping angle-closure glaucoma YAG laser iridotomy or surgical iridectomy was performed as part of treatment.
The initial characteristics of the affected eyes (refractive state, intraocular pressure, anterior chamber depth, iris contour, gonioscopic features, extent and severity of synechia formation and result of dark-room testing in six eyes) are recorded, and also the influence on these features of iridotomy or iridectomy. lntraocular pressure was reduced on average by 2.46 mmHg (1.72 mmHg in nontrabeculectomised eyes) (P<0.02), and anterior chambers deepened on average by 0.05 mm (P<0.05). Extension of peripheral anterior synechiae was recorded in nine eyes.     

毛果芸香碱防止Nd∶YAG激光虹膜切除术后眼压升高

目的:了解毛果芸香碱是否能有效降低棕色虹膜人种激光虹膜切除术后眼压急性升高。方法:原发性闭角型青光眼48例58眼,按年龄、性别进行匹配,分为治疗组和对照组。治疗组术前30min和术后即刻滴用20g/L毛果芸香碱,对照组滴用安慰剂。术后0.5,1.0,1.5,2.0,3.5h观察眼压和其他情况。结果:激光治疗后,治疗组和对照组眼压最大升高值分别为0.62±0.67kPa(1kPa=7.5mmHg)和1.13±0.87kPa,两组间差异有显著性(P=0.03)。治疗组的眼压明显下降发生于Nd∶YAG激光虹膜切除术后0.5,1.0和1.5h。除治疗组激光虹膜切除术后瞳孔直径明显小于对照组外,未见其他眼部和全身的副作用。结论:20g/L毛果芸香碱在棕色人种中可以有效地防止Nd∶YAG激光虹膜切除术后眼压升高。     

Nd:YAG laser iridotomy in the management of secondary glaucoma associated with Behçet's disease

PURPOSE: To report the outcome of Nd:YAG laser iridotomy in the management of secondary glaucoma associated with Beh?et's disease (BD). METHODS: In this prospective study, Nd:YAG laser iridotomy was performed on eyes with secondary angle-closure and pupillary block glaucoma associated with BD. The pretreatment and post-treatment intraocular pressures (IOP) and the number of antiglaucoma medications were compared by Mann-Whitney U test. RESULTS: The study consisted of 16 eyes of 11 patients (2 female, 9 male, mean age 39.2+/-8.9 years). Post-treatment follow-up ranged from 6 to 36 months (mean 13.8+/-8.9). The mean IOP was 21.6+/-2.5 mmHg on 2.5+/-0.6 medications before iridotomy. IOP reduced to 17.7+/-2.5 mmHg on 1+/-0.6 medications at the first month and 17.1+/-3.2 mmHg on 1.7+/-0.9 medications at the sixth month of treatment. The differences between IOP and number of antiglaucoma medications at baseline and at the sixth month of the treatment was statistically significant (p<0.00001). For four eyes trabeculectomy with mitomycin C and for one eye Ahmed valve implantation were performed in the follow-up period. CONCLUSIONS: Nd:YAG laser iridotomy can provide reduction of IOP and the number of antiglaucoma medications in selected cases with secondary glaucoma associated with Behcet's disease.     

氪离子与Q-开关Nd∶YAG激光联合激光虹膜切除术的远期疗效

目的:观察氪离子激光与Q-开关Nd∶YAG激光联合应用治疗原发性闭角型青光眼的远期疗效,并与近期疗效比较。方法:对我院39例(48眼)原发性闭角型青光眼患者,采用氪离子激光与Q-开关Nd∶YAG激光联合应用的方法,行激光周边虹膜切除术。评价术后1a与7a的疗效,并进行统计学比较。结果:虹膜透切率达100.0%,一次透切成功率达97.9%。术后1a随访时发现眼压在正常水平内,且均值比术前低;术后7a随访眼压与1a无统计学差异。视力情况在术后1a不变或轻度改善,但在第2次随访时发现有5例(7眼)视力轻度下降。房角情况在术后1a也较术前略为改善,且这种改善维持到第2次随访时。至于周边前房深度,术后1a随访时明显强于术前,第2次随访时发现新出现5例患者周边前房深度变浅;视野情况术后1a与术后7a无明显变化,均发现早期青光眼视野缺损消失。结论:联合激光虹膜切除术是预防和治疗原发性闭角型青光眼临床前期的有效术式,近、远期疗效确切,是一种较为理想的术式,可在相当时期内有效预防青光眼急性发作。     

聯合倍頻及Nd:YAG激光周邊虹膜切開術

目的觀察聯合應用倍頻NdYAG和NdYAG激光對閉角型青光眼進行周邊虹膜切閉術的效果.方法對82例(102眼)閉角型青光眼患者,用倍頻NdYAG激光對虹膜作一"蜂巢"狀創口,用NdYAG激光切透虹膜.結果聯合激光1次虹膜切開成功101眼(99.02%),術後3月眼壓有所下降.并發癥有虹膜切口出血2眼;切閉孔1月後再閉鎖1眼;角膜内皮損傷5眼;術眼均有不同程度虹膜炎,抗炎治療可吸收.結論聯合激光周邊虹膜切開術治療閉角型青光眼效果確切,并發癥發生率低.