激光虹膜成形术联合YAG激光与传统小梁切除术治疗闭角型青光眼的疗效比较
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Efficiency of glaucoma treated by laser iridoplasty combined with YAG laser or by traditional trabeculectomy
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    摘要:

    目的:探讨激光虹膜成形术联合YAG激光治疗青光眼与传统小梁切除术治疗青光眼的临床效果。

    方法:回顾性分析60例60眼闭角型青光眼患者临床资料,行激光虹膜成形术联合YAG激光虹膜切开术者纳入观察组(38例38眼),行传统小梁切除术者纳入对照组(22例22眼)。比较术前和术后1、3、12mo时,两组患者眼压(intraocular pressure,IOP)、房角开放距离(angle open distance,AOD500)、中央前房深度(anterior chamber depth,ACD)、角膜内皮细胞密度(corneal endothelial cell density,ECD)变化,分析术后12mo内两组患者并发症发生情况。

    结果:术后1、3、12mo时,两组患者IOP水平均较术前有显著下降,且观察组明显低于同期对照组(P<0.05); 观察组患者AOD500、ACD水平均较治疗前有显著提升,且明显高于同期对照组(P<0.05); 观察组患者ECD水平与术前比较均无统计学意义(P>0.05),但明显高于同期对照组(P<0.05)。术后12mo内,观察组患者并发症总发生率明显低于对照组(P<0.05)。

    结论:激光虹膜成形术联合YAG激光治疗青光眼可获得较为理想的治疗效果,其安全性较传统小梁切除术更佳,有利于患者预后眼功能恢复。

    Abstract:

    AIM: To discuss the clinical effects of laser iridoplasty combined with YAG laser or traditional trabeculectomy in the treatment of glaucoma.

    METHODS: The clinical data of 60 cases(60 eyes)of patients with glaucoma were retrospectively analyzed. The patients who underwent laser iridoplasty combined with YAG laser iridotomy were included in observation group(n=38, 38 eyes), and those who underwent traditional trabeculectomy were included in control group(n=22, 22 eyes). The changes of intraocular pressure(IOP), angle opening distance(AOD500), central anterior chamber depth(ACD), corneal endothelial cell density(ECD)were compared between the two groups before operation and at 1mo, 3mo and 12mo after operation, and the occurrence of complications within 12mo after operation were analyzed in the two groups.

    RESULTS: At 1mo, 3mo and 12mo after operation, the IOP level in the two groups was decreased significantly compared with that before operation, and the level in observation group was significantly lower than that in control group(P<0.05). The levels of AOD500 and ACD in observation group were significantly higher than those before treatment and than those in control group(P<0.05). There was no statistically significant difference in the ECD level of observation group compared with that before operation(P>0.05), but the level was significantly higher than that in control group(P<0.05). Within 12mo after operation, the total incidence rate of complications in observation group was significantly lower than that in control group(P<0.05).

    CONCLUSION: Laser iridoplasty combined with YAG laser for glaucoma can obtain an ideal treatment effect, and its safety is better than traditional trabeculectomy and it is beneficial to the recovery of ocular function.

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陈娜,王伟,刘亚,等.激光虹膜成形术联合YAG激光与传统小梁切除术治疗闭角型青光眼的疗效比较.国际眼科杂志, 2018,18(9):1648-1651.

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  • 收稿日期:2018-04-29
  • 最后修改日期:2018-08-07
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  • 在线发布日期: 2018-08-17
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