氪激光周边虹膜成形术治疗青光眼急性发作的临床研究

目的探讨氪激光周边虹膜成形术治疗原发性闭角型青光眼急性发作的安全性和有效性。方法原发性闭角型青光眼第一次急性发作者，经检查确诊后立即给予1％匹罗卡品及0．5％噻吗心安点眼，1h后眼压仍不能下降至40mmHg以下者24例24眼行氪激光周边虹膜成形术，观察治疗前及治疗后30min、1、2、24h的症状、视力、角膜水肿、眼压及前房角变化。结果氪激光周边虹膜成形术30min后，眼压从42～81mmHg降至25～72mmHg，平均下降10．7％；术后1h眼压为15～47mmHg，平均下降58．2％；术后2h眼压为12～28mmHg，平均下降71．4％；术后24h眼压为9—18mmHg，均降至正常，平均下降82．7％。激光治疗后患者不适症状迅速缓解，视力快速提高，角膜水肿消退，前房角有不同程度的加宽。结论氪激光周边虹膜成形术能机械性拉开房角，迅速降低原发性闭角型青光眼急性发作期的眼压，起效快，并发症少，是治疗青光眼急性发作的一种安全有效的方法。

The clinical study on Krypton laser peripheral iridoplasty for the acute attack of glaucoma

Objective To evalute the intraocular pressure-lowering effects and safety of Krypton laser peripheral iridoplasty for the acute attack of the primary angle-closure glaucoma. Methods Twenty-four patients were included,who were the first acute attack of the primary angle-closure glaucome. They were prescribed 1% pilocarpine once per 10 minutes and 0. 5% timolol once. One hour later,IOP is still above or equal 40 mm Hg. Symptoms,visual acuity, corneal edema, IOP and the angle of anterior chamber were observed preoperatively and 30 min, 1 h,2 h, 24 h postoperatively. Results 30 min after treatment, IOP decreased from 42 - 81 mm Hg to 25 - 72 mm Hg, 10.7% decreased;lh later,IOP were 15-47 mm Hg,58.2% decreased;2 h later,IOP were 12- 28 mm Hg, 71.4% decreased;24 h later,IOP were 9 - 18 mm Hg,82.7% decreased. After laser treatment,the uncomfortable symptoms were resolved quickly, visual acuity risen fast, corneal edema disappeared and the anterior chamber-angle widened differently. Conclusion Laser peripheral iridoplasty can mechanically open the anterior chamber angle and rapidly reduce the IOP of the acute attack of the primary angle-closure glaucoma,few complications. It is an ef- fective and safe method for acute attack of glaucoma.