小梁切开联合虹膜根切术治疗原发性闭角型青光眼

目的 观察外路小梁切开术联合虹膜周边切除治疗原发性闭角型青光眼的疗效.方法 对31例(31眼)原发性闭角型青光眼行外路小梁切开及虹膜周边切除术.其中急性闭角型青光眼22例,慢性闭角型青光眼9例.术后1周,1、3、6个月观察患者眼压和房角情况.结果 术后1个月和3个月,不用降眼压药眼压≤21 mm Hg(1 mm Hg=0.133 kPa)者分别为29例和27例,完全成功率分别为93.5%和87.1%.19例(19眼)随访6个月,不用降眼压药眼压≤21 mm Hg者16例(84.2%).术后房角检查显示上方120°范围房角开放和小梁组织切开的裂隙.术后并发症:前房出血31眼,均自行吸收,后弹力层损伤6眼、虹膜根部断离2眼、虹膜后粘连4眼.结论 外路小梁切开联合周边虹膜切除术能有效治疗原发性闭角型青光眼.

Treatment of primary angle-closure glaucoma with external trabeculotomy combined with peripheral iridectomy

Objective To investigate the effect of external trabeculotomy combined with peripheral iridectomy on the treatment of primary angle-closure glaucoma. Methods External trabeculotomy combined with peripheral iridectomy was performed on 31 eyes from 31 patients with primary angle-closure glaucoma, which included 22 acute cases and 9 chronic cases. The intraocnlar pressure and anterior chamber angle was examined before and 1 week, 1 month, 3 months, 6 months after the operation. Results Patients were followed up for 3 months in 31 cases and for 6 months in 19 cases. The intraocular pressure was less than 21 mm Hg（1 mm Hg =0. 133 kPa） in 29 patients one month postoperation and in 27 patients 3 months after the operation with the complete success rate being 93.5% and 87.1% respectively. Six months after the surgery, the intraocular pressure in 16 patients was less than 21 mm Hg with the complete successful rate being 84.2%. After the surgery, the incision gap could be observed in the trabecular around 120 degrees. The postoperative complications included anterior chamber hemorrhage in 31 eyes, descemet membrane damage in 6 eyes, iridodialysis in 2 eyes and posterior iris synechia in 4 eyes. Conclusions External trabeculotomy combined with peripheral iridectomy was an effective method in the treatment of primary angle-closure glaucoma.