State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Ophthalmology. 2012 Feb;119(2):283-8. doi: 10.1016/j.ophtha.2011.08.014. Epub 2011 Oct 29.
To determine the immediate changes in intraocular pressure (IOP) after laser peripheral iridotomy in primary angle-closure suspects.
Prospective, randomized controlled trial (split-body design).
Seven hundred thirty-four Chinese people 50 to 70 years of age.
Primary angle-closure suspects underwent iridotomy using a neodymium:yttrium-aluminum-garnet laser in 1 randomly selected eye, with the fellow eye serving as a control. Intraocular pressure was measured using Goldmann applanation tonometry before treatment and 1 hour and 2 weeks after treatment. Total energy used and complications were recorded. Risk factors for IOP rise after laser peripheral iridotomy were investigated.
Intraocular pressure.
The proportion of treated eyes with an IOP spike (an elevation of ≥8 mmHg more than baseline) at 1 hour and 2 weeks after treatment was 9.8% (95% confidence interval [CI], 7.7-12.0) and 0.82% (95% CI, 0.2-1.5), respectively. Only 4 (0.54%) of 734 eyes (95% CI, 0.01-1.08) had an immediate posttreatment IOP of 30 mmHg or more and needed medical intervention. The average IOP 1 hour after treatment was 17.5±4.7 mmHg in the treated eyes, as compared with 15.2±2.6 mmHg in controls. At 2 weeks after treatment, these values were 15.6±3.4 mmHg in treated eyes and 15.1±2.7 mmHg in controls (P<0.001). No significant difference was detected in the baseline IOP of the treated and untreated eyes. Logistic regression showed that the incidence of IOP spike was associated with greater laser energy used and shallower central anterior chamber.
Laser peripheral iridotomy in primary angle-closure suspects resulted in significant IOP rise in 9.8% and 0.82% of cases at 1 hour and 2 weeks, respectively. Eyes in which more laser energy and a higher number of laser pulses were used and those with shallower central anterior chambers were at increased risk for IOP spikes at 1 hour after laser peripheral iridotomy.
确定原发性闭角型青光眼疑似患者行激光周边虹膜切开术后眼内压（IOP）的即刻变化。
前瞻性、随机对照试验（分体式设计）。
734 名 50 至 70 岁的中国人。
使用钕：钇-铝-石榴石激光对原发性闭角型青光眼疑似患者的一只眼进行虹膜切开术，对侧眼作为对照。治疗前及治疗后 1 小时和 2 周，采用 Goldmann 压平眼压计测量眼内压。记录所用总能量和并发症。探讨激光周边虹膜切开术后 IOP 升高的危险因素。
眼内压。
治疗后 1 小时和 2 周时，IOP 升高（比基线升高≥8mmHg）的治疗眼比例分别为 9.8%（95%置信区间[CI]，7.7%至 12.0%）和 0.82%（95% CI，0.2%至 1.5%）。仅 4 只眼（0.54%）（95% CI，0.01%至 1.08%）在治疗后即刻 IOP 达到或超过 30mmHg，需要药物干预。治疗眼治疗后 1 小时平均眼压为 17.5±4.7mmHg，对照眼为 15.2±2.6mmHg。治疗后 2 周时，治疗眼和对照眼的眼压分别为 15.6±3.4mmHg和 15.1±2.7mmHg（P<0.001）。治疗眼和未治疗眼的基础眼压无显著差异。Logistic 回归显示，IOP 升高的发生率与所用激光能量较多和前房中央较浅有关。
原发性闭角型青光眼疑似患者行激光周边虹膜切开术后，分别有 9.8%和 0.82%的患者在 1 小时和 2 周时眼压显著升高。在激光周边虹膜切开术后 1 小时，激光能量使用较多、激光脉冲数较多、前房中央较浅的眼发生 IOP 升高的风险增加。
