摘要
目的评价掺钕钇铝石榴石(Nd:YAG)激光房角穿孔(laser goniopuncture,LGP)治疗改良黏小管切开扩张术(visco-canalostomy,VCO)后眼压升高的临床疗效及并发症。方法选取VCO后高眼压的20例(23眼)原发性开角型青光眼患者为研究对象作回顾性分析。当VCO术后眼压>21mmHg(1kPa=7.5mmHg)时,即在手术部位行LGP,观察术眼LGP术前、术后的眼压及术后并发症。结果LGP术前平均眼压为(24.09±5.25)mmHg,术后1h平均眼压降至(11.42±3.04)mmHg,激光后1周、1个月、3个月、6个月、12个月、24个月平均眼压分别为(12.32±2.54)mmHg、(12.43±2.52)mmHg、(12.96±3.42)mmHg、(14.52±2.70)mmHg、(15.04±2.92)mmHg、(16.20±3.06)mmHg,激光前后眼压比较差异有统计学意义(F=72.65,P<0.01);术后3周1例(1眼)一过性低眼压性浅前房伴脉络膜脱离,术后随访12个月发现1例(1眼)发生虹膜嵌顿,术后24个月虹膜周边前粘连1例(1眼)。结论LGP能有效和安全地改善VCO后小梁网-后弹力膜的房水低滤过状态,降低眼压,降低再次手术率,是VCO的有效补充;LGP提高了VCO的远期手术成功率,是安全有效的治疗方式。
Objective To evaluate the clincial efficacy and complications of neodymium：yttrium-aluminum-garnet（ND：YAG） laser goniopuncture（LGP） for high intraocular pressure（IOP） after viscocanalostomy（VCO）.Methods Retrospective ana-lysis was taken in 20 primary open-angle glaucoma patients（23 eyes） with high IOP after VCO.LGP was taken when IOP was more than 21 mmHg（1 kPa=7.5 mmHg） after VCO.IOP before and after LGP and complications after LGP were observed.Results The average IOP was（24.09±5.25） mmHg before LGP,decreased to（11.42±3.04）mmHg at 1 hour after LGP,and were（12.32±2.54）mmHg,（12.43±2.52）mmHg,（12.96±3.42）mmHg,（14.52±2.70）mmHg,（15.04±2.92）mmHg,（16.20±3.06） mmHg at 1 week,1 month,3 months,6 months,12 months and 24 months after laser treatment,respectively.There was statistical difference in IOP between before and after LGP（F=72.65,P0.01）.At 3 weeks after treatment,there was 1 case（1 eye） with transitory low IOP shallow of anterior chamber and detachment of choroid.All patients were followed up for 12 months,and there was 1 case（1 eye） with iridencleisis.At 24 months after treatment,there was 1 case（1 eye） with anterior synechia.Conclusions LGP is an effective and safe treatment to improve low filtration of aqueous humor across trabecular meshwork-posterior elastic memebrane after VCO,lower IOP,cut down operability for another operation and is an effective supplementary to VCO.LGP is a safe and effective treatment and can improve operative achievement ratio of VCO at a long term.
出处
《眼科新进展》
CAS
北大核心
2010年第1期72-74,共3页
Recent Advances in Ophthalmology
