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探讨我国不同类型原发性闭角型青光眼对周边虹膜切除术的反应,对不同房角关闭机制的闭角青光眼寻找合理的治疗方案。方法:采用房角镜检查技术、超声生物显微镜(ultrosoundmicroscopy,UBM)眼前段活体结构检查技术、UBM暗室试验技术,UBM眼前段图像处理技术,对不同类型闭角型青光眼周边虹膜切除术前后的房角状态,房角相关解剖结构进行了定性及半定量观察。结果:周边虹膜切除术后,房角及UBM检查发现:临床经过呈慢性经过的闭青(慢闭),特别是房角关闭呈爬行关闭者,术后约62.2%病例房角无明显增宽,在暗室条件下进行UBM检查发现,这类患者中约72%仍存在一个或一个以上象限的房角关闭,检查结果发现这类患者房角关闭除瞳孔阻滞因素外,尚有非瞳孔阻滞因素的参与。结论:我国闭青特别是慢闭关闭机制至少存在两种以上形式,周边虹膜切除术后应对房角状态进行再评价,尽早发现非瞳孔阻滞因素并给予合理处理。
To investigate the response of different types of primary angle-closure glaucoma to peripheral iridectomy in our country and to find a reasonable treatment for angle-closure glaucoma with different angle-closure mechanisms. Methods: Gonioscopy, UBM anterior segment biopsy technique, UBM darkroom test technique and UBM anterior segment image processing technique were used to assess the effect of different types of angle-closure glaucoma Angle state, angle related anatomical structures were qualitative and semi-quantitative observation. Results: Perioperative iridotomy and UBM examination revealed that the patients had chronic obstructive closed (CL), especially those with closed off angle. There was no significant difference in 62.2% of cases after operation Widening of the UBM in darkroom conditions found that about 72% of these patients still had one or more quadrants off and the findings showed that in addition to the pupillary block factors, Pupillary block factors involved. Conclusion: There are at least two kinds of forms of at least two types of closed-off mechanism in our country, especially in the case of slow-closing mechanism. The state of the angle should be re-evaluated after peripheral iridotomy, and non-pupillary block factors should be found as soon as possible and given reasonable treatment.