两种术式联合治疗原发性闭角型青光眼的降眼压作用研究

目的研究选择性激光小梁成形术联合激光周边虹膜成形术治疗原发性闭角型青光眼对患者术后眼压的影响及疗效。方法采用选择性激光小梁成形术联合激光周边虹膜成形术治疗原发性闭角型青光眼患者33例,观察疗效及术后降眼压作用。结果本组患者术后1、7 d的平均眼压均显著高于术前,而术后1 d与术后7 d相比无显著差异,3个时间点(术前与术后1、7 d)的平均用药指数相比无显著差异;在平均房水流畅系数方面,术后7 d显著高于术后1 d和术前,术后1 d显著高于术前。术中照射眼部明显刺痛或不适感患者17例(24眼),术后即出现睫状充血35眼,术后1 d进行裂隙灯检查发现前房闪辉患者40眼,未给予特殊处理,均于术后1周时复查全部好转。结论选择性激光小梁成形术联合激光周边虹膜成形术可以有效降低原发性闭角型青光眼患者的眼压,疗效确切,是治疗此类患者的良好选择。

Research on the effect of lowering intraocular pressure of two operative methods for primary angle-closure glaucoma

Objective To study the influences and therapeutic effects of selective laser trabeculoplasty combined with laser peripheral iridoplasty on postoperative intraocular pressure of patients with primary angle-closure glaucoma.Methods Selective laser trabeculoplasty combined with laser peripheral iridoplasty was applied to treat 33 patients with primary angle-closure glaucoma,and the therapeutic effects and postoperative effects of lowering intraocular pressure were observed.Results The mean intraocular pressure of patients in this group on the first and seventh days was significantly higher than before operation,whereas there was no significant difference between the first day and the seventh day after operation,and no conspicuous difference among average medication indexes of 3 time points(before operation,the first and seventh days after operation).The average coefficient of aqueous outflow on the seventh day after operation was markedly higher than that on the first day and before operation,and that on the first day after operation obviously higher than before operation.Conspicuously stabbing pain or discomforts manifested in 17 patients(24 eyes) by irradiating eyes during operation,and ciliary congestion in 35 eyes immediately after operation.Slit-lamp examination on the first day indicated that 40 eyes with anterior chamber flare,without special treatment,completely became better at the time of reexamination 1 week after operation.Conclusion The combination of selective laser trabeculoplasty and laser peripheral iridoplasty,with specific curative effects,can effectively lower the intraocular pressure of patients with primary angle-closure glaucoma,which is a good choice for such patients.