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目的评价激光虹膜切除术治疗早期原发性闭角型青光眼的疗效。方法对62例(112眼)早期原发性闭角型青光眼按不同类型分为3组,分别行激光虹膜切除术,观察术前及术后1h、1周、3月的眼压、前房深度、前房角等变化情况。结果所有病例治疗后中央及周边前房深度都有不同程度加深。暗室试验阳性组治疗后平均眼压(13.71±2.29)mmHg,且房角未出现关闭。原发性急性闭角型青光眼组治疗后平均眼压(14.69±2.43)mmHg,11.9%的眼出现了15°以内的房角关闭。原发性慢性闭角型青光眼组治疗后平均眼压(23.18±5.66)mmHg,房角关闭增加15°以内5只眼,增加30°～60°的3眼,共占50.00%。结论激光虹膜切除术是预防和治疗早期闭角型青光眼,保护视功能的一种有效手段。但由于慢性闭角型青光眼发病机制复杂,应通过术前病例的合理选择及术后的密切随访,有效控制术后病情的发展。
Objective To evaluate the effect of laser iridotomy on early primary angle-closure glaucoma. Methods 62 cases (112 eyes) of early primary angle-closure glaucoma were divided into 3 groups according to different types. Laser iridectomy was performed respectively. The intraocular pressure at 1h, 1 week and 3 months after operation were observed. The anterior chamber Depth, anterior chamber angle and other changes. Results The depth of central and peripheral anterior chamber in all cases was deepened to varying degrees. The average intraocular pressure (13.71 ± 2.29) mmHg in the darkroom test positive group after treatment did not appear to close. The mean IOP was 14.69 ± 2.43 mmHg in primary acute angle-closure glaucoma group, and the angle was closed within 15 ° in 11.9% of eyes. The average IOP was 23.18 ± 5.66 mmHg in primary chronic angle-closure glaucoma group, 5 eyes were closed within 15 °, and 3 eyes increased 30 ° ~ 60 °, accounting for 50.00%. Conclusion Laser iridectomy is an effective means of preventing and treating early angle-closure glaucoma and protecting visual function. However, due to the complicated pathogenesis of chronic angle-closure glaucoma, the reasonable choice of preoperative cases and close follow-up after surgery should effectively control the postoperative development of the disease.