Savelsbergh-Fillette M P, Demailly P
Service d'ophtalmologie, Hôpital St-Joseph, Paris.
J Fr Ophtalmol. 1988;11(4):349-56.
The subject is to compare the middle term efficiency of surgical peripheral iridotomy and Argon laser iridotomy for primary closed angle glaucoma. We have considered reopened angles on 360 degrees after a crisis of closed angle; eyes with a positive "neosynephrine - pilocarpine" test; the second eye of a primary closed angle glaucoma and primary mixed glaucoma. Sixty affected eyes have been divided in two groups in a randomized study. Group A: Thirty eyes requiring a bilateral surgical peripheral iridectomy, Group B: Thirty eyes requiring a bilateral Argon laser iridotomy. The patients are regularly followed at intervals of: one week, three months, six months, one year and two years. Four parameters have been researched: 1. Intraocular pressure between 9 h-12 h a.m. Intraocular pressures lower or equal to 22 mmHg were considered to be successes. 2. Far visual acuity with correct lenses. 3. Opacity of the crystalline lenses: normal or sclerosed (0, +/-, +) cataract (++, ). 4. Post-operative complications. Some cases have required several periods of Argon laser photocoagulation (colorless iris, older patients) but we prefer a proper result immediately in order not to take any risks with pupillary blocking-up. The statistical analysis gives the following results: Same tonometric results according to the different technics even if the treatment has been prophylactic (positive provocation test; second eye) or curative (primary closed-angle glaucoma with solvable crisis; mixed glaucoma). No significant difference of visual acuity between the two groups after two years. Similarly, we have not found a significant difference between both techniques in each considered age group two years after the operation.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究旨在比较手术周边虹膜切除术与氩激光虹膜切开术治疗原发性闭角型青光眼的中期疗效。我们纳入了闭角型青光眼发作后360度房角重新开放的患者;“新福林-毛果芸香碱”试验阳性的患者;原发性闭角型青光眼和原发性混合型青光眼的对侧眼。在一项随机研究中,60只患眼被分为两组。A组:30只需要进行双侧手术周边虹膜切除术的眼睛;B组:30只需要进行双侧氩激光虹膜切开术的眼睛。患者定期随访,随访间隔为:1周、3个月、6个月、1年和2年。研究了四个参数:1. 上午9点至12点的眼压。眼压低于或等于22mmHg被视为成功。2. 矫正镜片后的远视力。3. 晶状体混浊情况:正常或硬化(0、+/-、+)、白内障(++、+++)。4. 术后并发症。一些病例需要多次进行氩激光光凝治疗(无色虹膜、老年患者),但我们更倾向于立即获得良好的效果,以免出现瞳孔阻滞的风险。统计分析结果如下:无论治疗是预防性的(激发试验阳性;对侧眼)还是治疗性的(原发性闭角型青光眼伴可缓解的发作;混合型青光眼),不同技术的眼压测量结果相同。两年后两组视力无显著差异。同样,术后两年在各年龄组中,两种技术之间也未发现显著差异。(摘要截断于250字)