摘要
目的确定急性闭角型青光眼(AACG)行激光虹膜切开术的预后因素。方法回顾性分析自2014年6月—2016年6月77例急性原发性闭角型青光眼(AACG)患者77眼,患者初始眼压(IOP)高于40 mmHg的病历资料。所有患者均接受最大药物治疗(MTMT),其次为激光虹膜切开术。为了比较激光虹膜切开术有效的影响因素,随访中将大于21 mmHg的眼压定义为需要医疗或手术治疗的眼压。结果成功的激光虹膜切开术达到了59.7%(46/77眼)。31只眼(40.3%)在随访中表现出眼压的增高,其中30只眼在第一次发作后6个月内发生了眼压增高。42例首次发作MTMT后眼压下降超过30.0%的患者与35例眼压下降不足30.0%的患者相比,成功率更高(92.9%),其中24眼(72.7%)静脉注射高渗药物治疗后IOP可降低30%(P=0.012)。发生症状后7 d内治疗的患者的成功率高于7 d后治疗的患者。结论患者在发生症状后7 d内进行激光虹膜切开术的治疗效果更佳,患者在最大药物治疗后IOP降低超过30.0%以上行激光虹膜切开术的治疗效果更佳。
Objective To determine the prognostic factors of laser iridotomy in acute angle-closure glaucoma (AACG). Methods A retrospective analysis of 77 patients with acute primary angle-closure glaucoma (AACG) from June 2014 to June 2016 was performed. The patient's initial intraocular pressure (IOP) was higher than 40 mmHg. All patients received maximum drug therapy (MTMT) followed by laser iridotomy. In order to compare the effective factors of laser iridotomy, intraocular pressure greater than 21 mmHg was defined as intraocular pressure requiring medical or surgical treatment during follow-up. Results Successful laser iridotomy reached 59.7%(46/77 eyes). Thirty-one eyes (40.3%) showed an increase in intraocular pressure during follow-up, and 30 of them had an increase in intraocular pressure within 6 months after the first episode. 42 patients with a decrease in intraocular pressure more than 30.0% after the first episode of MTMT had a higher success rate (92.9%) than 35 patients with a decrease in intraocular pressure of less than 30.0%, of which 24 eyes (72.7%) received intravenous hypertonic medication. The post-IOP can be reduced by 30.0%(P=0.012). The success rate of patients treated within seven days of symptom onset was higher than that of patients treated after seven days. Conclusion The patients who underwent laser iridotomy within 7 days after the onset of symptoms were better. The patients who underwent laser iridotomy with a maximum IOP reduction of more than 30% after the maximum drug treatment were better.
作者
付颖
FU Ying(Miyun Teaching Hospital, Capital Medical University, Beijing, 101500 China)
出处
《中外医疗》
2019年第10期96-98,共3页
China & Foreign Medical Treatment
