YAG激光周边虹膜切开术对难治性青光眼治疗后眼内压的影响

分析钇铝石榴石晶体(YAG)激光周边虹膜切开术对难治性青光眼治疗后眼内压的影响。回顾性分析80例(116眼)行YAG激光周边切开术的难治性青光眼患者的临床资料,结果显示术后1 h不同能量患者眼压均有一过性升高(P<0.05),0~45 mJ组术后1 h眼压低于46~80 mJ组、＞80 mJ组(P<0.05)；46~80 mJ组术后1 h眼压又低于＞80 mJ组(P<0.05)；术后1 h ＞80 mJ患者高眼压发生率高于0~45 mJ组(P<0.05),其余各时间点比较差异无统计学意义(P>0.05)；术后1 h,难治性青光眼房水闪光值上升(P<0.05),术后1周较术后1 h降低(P<0.05),术后4 周恢复至术前水平；激光能量、房水闪光值均与难治性青光眼患者术后1 h眼压呈正相关(r=0.485、0.612,P<0.05)。因此,激光能量、房水闪光值均与难治性青光眼YAG激光周边虹膜切开术后早期眼压变化有关,即随激光能量及房水闪光值的增加,患者术后早期眼压上升。

Effects of YAG laser peripheral iridotomy on intraocular pressure after treatment for refractory glaucoma

To analyze the effects of yttrium aluminum garnet (YAG) laser peripheral iridotomy on intraocular pressure after treatment for refractory glaucoma, the clinical data of 80 patients (116 affected eyes) with refractory glaucoma who underwent YAG laser peripheral iridotomy were analyzed retrospectively. The results showed that at 1h after surgery, there was transient increase in intraocular pressure of patients with different energy (P<0.05). At 1h after surgery, intraocular pressure in 0~45 mJ group was lower than that in 46-80 mJ group and >80 mJ group (P<0.05). The intraocular pressure in 46~80 mJ group was lower than that in >80 mJ group (P<0.05). At 1h after surgery, incidence of high intraocular pressure in 80 mJ group was higher than that in 0-45 mJ group (P<0.05). There was no significant difference in the other time points (P>0.05). At 1h after surgery, aqueous humour flash values of refractory glaucoma were increased (P<0.05). The above indexes at 1w after surgery were lower than those at 1h after surgery (P<0.05), returning to previous level at 4w after surgery. The laser energy and flash values of aqueous humour were positively correlated with intraocular pressure of refractory glaucoma patients at1 h after surgery (r=0.485,0.612, P<0.05). Therefore, laser energy and flash values of aqueous humour are related to change of early intraocular pressure after YAG laser peripheral iridotomy for refractory glaucoma. That is, with increase of laser energy and flash values of aqueous humour, postoperative early intraocular pressure is increased.