选择性激光小梁成形术治疗慢性闭角型青光眼的临床疗效观察

目的：评价选择性激光小梁成形术（SLT）治疗慢性闭角型青光眼的疗效及安全洼。方法：前瞻陛、非随机性选择早期慢性闭角型青光眼患者9例15眼，慢性闭角型青光眼激光虹膜切除术后13例22眼，应用选择性激光小梁成形术治疗。观察患者术后6个月的眼压以及视力、视野、房角及角膜内皮数等的变化。结果：患者术前平均眼压（23．07±4．01）mmHg，术后第1小时眼压为（25．07±3．65）mmHg，术后1d眼压降至（16．45±3．03）mmHg，术后1周为（18．39±2．71）mmHg，1个月为（18．14±2．15）mmHg，3个月为（19．04±2．35）mmHg，6个月为（18．17±2．23）mmHg。术后1d、1周、1月、3月、6月的眼压与术前相比明显下降，差异有统计学意义（P〈0．05）。术后1d眼压下降最明显，术后一过性眼压升高为最常见的并发症。术后6个月随访视力、房角、视野、角膜内皮计数无变化。结论：选择性激光小梁成形术可以安全有效地降低房角大部分开放的慢性闭角型青光眼的眼压。

Effect of selective laser trabeculoplasty on chronic primary angle-closure glaucoma

Objective： To investigate the efficacy and safety of selective laser trabeculoplasty （SLT）in the treatment of chronic primary angle-closure glaucoma （CPACG）. Methods： A prospective non- randomized clinical trial was designed. CPACG patients with medically uncontrolled intraocular pressure in spite of previous iridotomy and opened most angle were enrolled. Results： 37 eyes of 22 patients with CPACG were included in this study. The mean preoperative lOP was （23.07±4.01） mmHg. The mean IOP was （25.07±3.65）mmHg after treatment at 1 hour. At the end of 1 day and 1 week,l, 3 and 6 month of follow-up period the lOP was（ 16.45±3.03）mmHg, （18.39±2.71） mmHg, （18.14±2.15） mmHg, （19.04±2.35） mmHg, （18.17 ±2.23）mmHg. There were statistically significant difference in preoperative lOP and postoperative IOP.IOP reduction was obvious after postoperative 1 day. Transient pressure spike was the most common complications. For all cases,the visual acuity,anterior chamber angle, visual fields and corneal endothelial counting had no obvious changes. Conclusion： SLT is a safe and effective method of reducing lOP in CPACG patients with most opened angle.