摘要
目的评价激光房角穿刺治疗非穿透小梁手术后眼压升高的临床疗效和安全性。方法以21例(23眼)开角型青光眼患者为研究对象作前瞻性研究,当非穿透小梁手术后眼压>21mmHg时,即在手术部位行Nd:YAG激光房角穿刺。结果激光前平均眼压(25.1±2.4)mmHg,房角穿刺后1h的平均眼压降至(14.2±3.9)mmHg(P<0.01)。激光后随访(10.5±4.1)个月,最后一次随访的平均眼压为(16.0±3.6)mmHg(P<0.01)。并发症为浅前房、脉络膜脱离1眼,虹膜周边前粘连1眼。结论Nd:YAG激光房角穿刺能有效和安全地治疗非穿透小梁手术后小梁网-后弹力膜的房水低滤过状态,降低再次手术率。
Objective Non-penetrating trabecular surgery （NPTS） has an advantage over traditional trabeculectomy because of its less postoperative complication. However, the procedure may fail due to insufficient filtration through the trabeculo- Descemet＇ s membrane. The objective of this study was to investigate the efficacy and safety of Neodymium： yttrium-aluminumgarnet （Nd：YAG） goniopuncture in eyes with elevated intraocular pressure（lOP） after NPTS. Methods It was a prospective clinical study. Twentyone patients （23 eyes） with lOP more than 21 mmHg following NPTS received Nd： YAG goniopuncture. Laser goniopuncture was performed using the Q-switched mode with an energy ranging from 3 to 6 mJ and pulses ranging from 4 to 13. The procedure was considered as success when lOP was no more than 15 mmHg without antiglaucoma medication. The mean time between goniopuncture application and NPTS was （7.2 ± 4.8 ） months, and the mean follow-up time after laser treatmen was （10.5±4.1） months. Results The mean baseline lOP was （25.1 ±2.4） mmHg and decreased to （14.2 ±3.9）mmHg 1 hour after laser goniopuncture（z = - 20.46, P 〈 0. 001 ）. The mean lOP at the end of follow-up was （ 16. 0 ＋ 3.6 ） mmHg （ t = 10. 337 6,P 〈0. 001）. The success rate of the laser procedure was 78.3% at 1 hour and 50. 0% at 18 months. Complications included shallow anterior chamber and choroidal detachment （ 1 eye） and iris anterior synechia （ 1 eye） respectively. Conclusion Nd：YAG goniopuncture is an effective and safe treatment for the uncontrol lOP after NPTS through the trabeculo- Descemet＇ s membrane,and this procedure can reduce the incidence of re-operation.
出处
《眼科研究》
CSCD
北大核心
2007年第4期299-302,共4页
Chinese Ophthalmic Research
关键词
青光眼
开角型
眼压
激光
房角穿刺
glaucoma
open-angle
intraocular pressure
laser
goniopuncture
