国内原发性闭角型青光眼治疗方案及手术指征的问卷调查

目的 了解眼科医生对原发性闭角型青光眼的主要治疗方法的选择及其依据.方法 在第十届全国眼科会议期间(2005年9月11日)于青光眼会场参会的眼科医生.采用问卷调查的形式,调查表内容包括:被调查者基本信息、对原发性闭角犁青光眼治疗方法的选择及选择依据.主要分析调查眼科医生中针对不同类型闭角型青光眼进行不同治疗方法选择的比例和不同手术指征的比例.结果 共发出问卷表330份,收回293份.接受本次问卷调查的与会代表涵盖了29个省市.经过逻辑检查和完整型检查,有效问卷262份,有效应答率为79.4%.在被调查的医生中53.1%(139/262)的医生认为,氩激光周边虹膜成形术可以用于急性闭角型青光眼的治疗,31.3%的医生使用过氩激光周边虹膜成形术治疗急性闭角型青光眼.对于早期原发性闭角型青光眼,39.3%(103/262)的医生选择药物作为首选治疗方案,而58.8%的医牛选择激光周边虹膜切除术作为首选.急性闭角型青光眼中进行小梁切除术的比例为66.5%,而对慢性闭角型青光眼,73.3%的医生选择小梁切除术作为首选的治疗方式.43.1%的医生在闭角型青光眼的小梁切除术中常规使用了可拆除缝线技术,而18.3%的医生从不使用.结论 国内闭角型青光眼进行滤过手术的比例较高,原因可能在于眼科将小梁切除术作为了闭角型青光眼治疗的一线治疗方案;采用激光方式进行周边虹膜切除术,由于设备原因在国内还远未普及;可拆除缝线技术在闭角型青光眼的应用率较低.

Therapeutic patterns of primary angle-closure glaucoma in mainland China:a national survey among ophthalmologists

Objective This study is to describe the current practice pattern of treatment on primary angle closure (PAC) or primary angle closure glaucoma (PACG).Methods all attendees to the glaucoma sec tion of the 10th Congress of the Chinese Ophthalmological Society in Tianjin (September 11th,2005.),were invited to answer a detailed questionnaire regarding to the treatment choice for patients with PAC or PACG and acute angle closure glaucoma.Results 262 (79.4% of attendees) ophthalmologists responded were from 29 provinces (this represents all of China except Taiwan and Hainan province).53.1% (139/262) docotors be lieved that argon laser iridoplasty was a good treatment for acute angle closure (AAC).31.3% of the paritci pants had the experience of iridoplasty before.Incisional peripheral iridotomy (PI) was more frequently used (60%) in early PAC than laser PI (40%).39.3% (103/262) of them prefered to use medications as the first choice for early stage of PAC,while 58.8% prefered PI first.Trabeculectomy was considered to be required in 66.5% of AAC cases and 73.3% of chronic PACG patients.43.1% of the respondents claimed to use releasable sutures in 80% of patients with PACG,while 18.3% never used them.Conclusion Ophthalmologists report that they more oten use surgical iridectomy than laser iridotomy,likely due to limited access to equipment.A large percentage of angle closure patients were believed to have been undergone trabeculectomy as the first line therapy.Releasable suture was not frequently used in the trabeculectomy for patients with PACG.