Arnavielle Stéphane, Creuzot-Garcher Catherine, Bron Alain M
Department of Ophthalmology, University of Burgundy, General Hospital, 3 rue Faubourg Raines, 21033, Dijon cédex BP 1519, France.
Graefes Arch Clin Exp Ophthalmol. 2007 Mar;245(3):345-50. doi: 10.1007/s00417-006-0465-5. Epub 2006 Nov 17.
The purpose was to evaluate the efficacy and the safety of anterior chamber paracentesis (ACP) in acute elevation of intraocular pressure (IOP).
We prospectively enrolled 20 patients who presented with acute unilateral elevation of IOP above 50 mmHg. IOP was measured before, 10 min, and 1, 7 and 30 days after ACP. The outcome at 1 year was available in 19 patients.
The patients included 14 cases of primary acute angle-closure attacks and six cases of secondary glaucoma. IOP decreased from 53.4 +/- 4.2 mmHg to 24.1 +/- 12.5 mmHg at 10 min, to 18.2 +/- 11.1 mmHg at 24 h, and to 16.4 +/- 10.7 mmHg 7 days after ACP. ACP combined with antiglaucomatous medications provided immediate relief of symptoms in all cases and improvement of corneal oedema in 17 cases. We noted three failures in secondary glaucoma. We performed a laser peripheral iridotomy (LPI) in 14 patients and a surgical procedure in 17 eyes. No complications related to ACP were observed.
ACP is a safe and effective procedure for acute elevation of IOP in acute primary primary angle-closure but only remains an add-on therapy to usual treatments. However, this technique must be evaluated in larger series.
评估前房穿刺术（ACP）治疗急性眼压（IOP）升高的有效性和安全性。
我们前瞻性纳入了20例急性单侧眼压升高至50 mmHg以上的患者。在进行前房穿刺术之前、穿刺后10分钟、1天、7天和30天测量眼压。19例患者有1年的随访结果。
患者包括14例原发性急性闭角型青光眼发作和6例继发性青光眼。前房穿刺术后10分钟眼压从53.4±4.2 mmHg降至24.1±12.5 mmHg，24小时降至18.2±11.1 mmHg，7天降至16.4±10.7 mmHg。前房穿刺术联合抗青光眼药物在所有病例中均能立即缓解症状，17例患者角膜水肿得到改善。我们注意到3例继发性青光眼治疗失败。我们对14例患者进行了激光周边虹膜切开术（LPI），对17只眼进行了手术。未观察到与前房穿刺术相关的并发症。
前房穿刺术是治疗急性原发性闭角型青光眼急性眼压升高的一种安全有效的方法，但仅是常规治疗的一种辅助治疗。然而，该技术必须在更大规模的研究中进行评估。
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