Q-开关Nd:YAG激光虹膜切除术治疗闭角型青光眼的疗效观察

目的:观察Q-开关Nd:YAG激光治疗闭角型青光眼的疗效。方法:收集212例236眼门诊及住院闭角型青光眼患者,其中原发性闭角型青光眼204例228眼,葡萄膜炎继发青光眼8例8眼,进行Q-开关Nd:YAG激光虹膜切除术,非接触压平眼压计测量眼压,观察Q-开关Nd:YAG激光虹膜切除术后临床效果。结果:随诊3～24mo,激光虹膜切除术治疗前眼压均值21.36mmHg,治疗后终末眼压均值19.25mmHg,眼压控制良好219眼,有效率92.8%,配合降眼压药物治疗,眼压控制正常11眼(4.7%),眼压升高6眼(2.5%),再次激光无效后行小梁切除术。激光治疗术后前房加深,房角有不同程度加宽,视野未明显改变。结论:Q-开关Nd:YAG激光虹膜切除术是一种治疗闭角型青光眼安全有效的方法。

Clinical effects of Q-switched Nd:YAG laser iridotomies for the angle-closure glaucoma

AIM:To evaluate the effects of Q-switched Nd:YAG laser iridotomies for the angle-closure glaucoma.·METHODS:We observed 212 patients(236 eyes)of angle-closure glaucoma in out-patient clinic or hospital,including 204 patients(228 eyes) of primary angle-closure glaucoma,and 8 patients(8 eyes) of secondary glaucoma following uveitis.All patients’ intraocular pressure(IOP) were measured before and after the Q-switched Nd:YAG laser iridotomies,and the clinical effects after the operation were evaluated.·RESULTS:Patients were followed up for 3-24 months,the average IOP before the Q-switched Nd:YAG laser iridotomies was 21.36mmHg,and 19.25mmHg after the operation.219 eyes’ IOP were in good control,the effective rate was 92.8%,and 11 eyes were in good control with medication,the rate was 4.7%,6 eyes were in bad control after the second Q-switched Nd:YAG laser iridotomies,the rate was 2.5%,and treated with trabeculectomy.The anterior chamber was deepened,the anterior chamber angle was widened,and the field of vision didn’t obviously changed after the operation.·CONCLUSION:The Q-switched Nd:YAG laser iridotomies is safe and effective for the angle-closure glaucoma.