激光虹膜周切术治疗早期闭角型青光眼临床观察

目的：观察早期闭角型青光眼患者激光虹膜周边切除术（laser peripheral iridectomy,LPI）的近、远期临床疗效。方法：对急性闭角型青光眼临床前期21例21眼和慢性闭角型青光眼早期15例15眼患者行LPI,随访1a,观察中央前房深度,房角宽度及眼压等情况。结果：急性闭角型青光眼临床前期和慢性闭角型青光眼早期LPI术后中央前房深度加深,房角增宽,眼压下降,但随访1a后慢性闭角型青光眼早期患者中央前房深度有所变浅、眼压回升,其中3例需药物控制眼压,1例药物控制眼压失败需行滤过性减压手术。结论：LPI治疗急性闭角型青光眼临床前期效果满意,慢性闭角型青光眼早期患者应注意LPI适应证的选择,对所有LPI患者,应密切随诊,以防止视功能进一步损害。

Clinical effect of laser peripheral iridectomy for the treatment of early angle-closure glaucoma

AIM: To observe the short-term and long-term clinical effect of laser peripheral iridectomy(LPI)for the treatment of early angle-closure glaucoma.

METHODS: The LPI was performed on 21 cases 21 eyes with acute primary angle-closure glaucoma in preclinical stage and 15 cases 15 eyes with chronic primary angle-closure glaucoma in early stage. The central anterior chamber depth, anterior chamber angle and intraocular pressure(IOP)were observed postoperatively. All cases were followed up for 1 year.

RESULTS: The central anterior chamber depth was significantly increased, the anterior chamber angles were wider, and the IOP was significantly decreased postoperatively in all cases. But 1 year after operation among patients with chronic primary angle-closure glaucoma in early stage, the central anterior chamber depth became thinner and the IOP increased, 3 cases needed topical anti-glaucoma drops to control their IOP, 1 case was performed filterable operation after no use of drug therapy to control their IOP.

CONCLUSION:LPI is an effective method to treat acute primary angle-closure glaucoma in preclinical stage, but it is need to pay attention to choice of indications in chronic primary angle-closure glaucoma in early stage. In order to avoid further damage on visual function, all cases which were performed LPI need close follow-up.