Department of Ophthalmology, Medical Faculty Carl Gustav Carus, Technische Universität, Dresden, Germany.
Acta Ophthalmol. 2019 Mar;97(2):e225-e230. doi: 10.1111/aos.13878. Epub 2018 Sep 21.
To investigate whether the peripheral thinning and shrinking of the iris as induced with Argon laser peripheral iridoplasty (ALPI) has an effect on intraocular pressure (IOP), angle structure and 3-D anterior segment (AS) morphology in Caucasians with chronic primary angle-closure (PAC) and primary angle-closure glaucoma (PACG).
Twenty-four eyes of 24 patients (age 67.7 ± 8.9 years; seven males; 17 females) diagnosed with PAC (n = 10) or PACG (n = 14) were assigned for ALPI prior to laser peripheral iridotomy (LPI) and consecutively enrolled in this prospective interventional study. Intraocular pressure (IOP) was measured with Goldmann applanation tonometry, angle structure with gonioscopy using the Shaffer grading system and AS morphology with the Pentacam rotating Scheimpflug camera prior to and 3 months after ALPI. Intraocular pressure (IOP)-lowering medication was not changed during follow-up.
Intraocular pressure (IOP) changed statistically significantly from 18.8 ± 3.6 to 14.7 ± 3.1 mmHg (p < 0.001). Gonioscopy showed a statistically significant angle widening in all four quadrants: nasally from Shaffer 1.04 ± 0.98 to 2.54 ± 1.1 (p < 0.001), superiorly from 0.39 ± 0.66 to 1.58 ± 1.21 (p < 0.001), temporally from 0.87 ± 1.01 to 2.17 ± 1.24 (p = 0.001) and inferiorly from 1.22 ± 0.74 to 2.75 ± 0.9 (p < 0.001). Pentacam parameters like anterior chamber depth, volume and angle did not increase statistically significantly.
Argon laser peripheral iridoplasty (ALPI) is a safe and effective procedure for reducing appositional angle-closure and thus IOP in nonacute PAC and PACG patients.
探讨氩激光周边虹膜成形术（ALPI）引起的虹膜周边变薄和收缩是否会影响慢性原发性闭角型青光眼（PAC）和原发性闭角型青光眼（PACG）的高加索人群的眼压（IOP）、角度结构和 3D 前节（AS）形态。
24 名患者（67.7±8.9 岁；7 名男性；17 名女性）的 24 只眼被诊断为 PAC（n=10）或 PACG（n=14），并在激光周边虹膜切开术（LPI）前进行 ALPI，并连续纳入这项前瞻性干预研究。在 ALPI 前后，使用 Goldmann 压平眼压计测量眼压（IOP），使用 Shaffer 分级系统进行房角镜检查测量房角结构，使用 Pentacam 旋转 Scheimpflug 相机测量 AS 形态。在随访期间，不改变降眼压药物。
眼压（IOP）从 18.8±3.6mmHg 统计学显著降低至 14.7±3.1mmHg（p<0.001）。房角镜检查显示所有四个象限的角度均有统计学显著增宽：鼻侧从 Shaffer 1.04±0.98 增加至 2.54±1.1（p<0.001），上方从 0.39±0.66 增加至 1.58±1.21（p<0.001），颞侧从 0.87±1.01 增加至 2.17±1.24（p=0.001），下方从 1.22±0.74 增加至 2.75±0.9（p<0.001）。Pentacam 参数如前房深度、体积和角度均无统计学显著增加。
氩激光周边虹膜成形术（ALPI）是一种安全有效的降低非急性 PAC 和 PACG 患者闭角性眼压的方法。
