激光周边虹膜成形术激光点数治疗急性闭角型青光眼的临床观察。

Clinical Observation of Laser Peripheral Iridoplasty with Number of Laser Shots in the Treatment of Acute Angle-Closure Glaucoma.

机构信息

Department of Ophthalmology, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin 300192, China.

出版信息

J Healthc Eng. 2022 Mar 15;2022:7968999. doi: 10.1155/2022/7968999. eCollection 2022.

DOI:10.1155/2022/7968999

PMID:35340231

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8941550/

Abstract

OBJECTIVE

To quantitatively study the intraocular pressure (IOP) control and chamber angle opening degree of patients with acute angle-closure glaucoma (stage of attack) treated by laser peripheral iridoplasty (LPIP) with different numbers of laser shots, and to evaluate the efficacy and safety of different numbers of laser shots.

METHODS

Fifty-five patients (60 eyes) with acute angle-closure glaucoma treated in our hospital from May 2019 to December 2020 were selected as the research subjects. All patients had poor intraocular pressure control (≥40 mmHg) after IOP-lowering drug therapy. The patients were randomly divided into three groups, 20 eyes in each group, and underwent laser peripheral iridoplasty (LPIP) with different numbers of laser shots (group I: 35 laser shots, group II: 45 laser shots, and group III: 60 laser shots). The best-corrected visual acuity, IOP, corneal condition, and opening degree of anterior chamber angle (ACA), namely, the trabecular-iris angle (TIA), angle opening distance at 500 m (AOD), and complications of patients before LPIP, 2 hours after LPIP, and 24 hours after LPIP were observed, and the opening degree of ACA were quantitatively measured.

RESULTS

The corrected visual acuity of the three groups after LPIP was improved to varying degrees, and the IOP decreased, TIA and AOD were increased compared with those before operation, and the differences were statistically significant ( < 0.05). There were statistically significant differences between group II and group I ( < 0.05). Four eyes in group I underwent LPIP again due to increased IOP. In group III, iris hemorrhage occurred in one eye and iris depigmentation occurred in one eye, and there was no statistical difference compared with group II ( > 0.05).

CONCLUSIONS

LPIP can effectively reduce preoperative IOP and increase ACA width in patients with persistent high IOP that failed to respond to drug therapy, and moderate numbers of laser shots can achieve satisfactory results and highest safety.

摘要

目的

定量研究激光周边虹膜成形术（LPIP）治疗急性闭角型青光眼（发作期）患者的眼压（IOP）控制和房角开放程度，并评估不同激光点数的疗效和安全性。

方法

选择 2019 年 5 月至 2020 年 12 月在我院治疗的 55 例（60 眼）急性闭角型青光眼患者为研究对象。所有患者经降眼压药物治疗后眼压控制不佳（≥40mmHg）。将患者随机分为三组，每组 20 眼，分别行不同激光点数的激光周边虹膜成形术（LPIP）（I 组：35 激光点，II 组：45 激光点，III 组：60 激光点）。观察患者 LPIP 前、LPIP 后 2 小时、LPIP 后 24 小时的最佳矫正视力、IOP、角膜情况及前房角（ACA）开口度，即小梁虹膜角（TIA）、500μm 处房角开口距离（AOD），并对 ACA 开口度进行定量测量。

结果

三组患者 LPIP 后矫正视力均有不同程度提高，IOP 降低，TIA 和 AOD 均较术前增加，差异有统计学意义（ < 0.05）。组 II 与组 I 比较差异有统计学意义（ < 0.05）。组 I 中有 4 眼因眼压升高再次行 LPIP。组 III 中 1 眼发生虹膜出血，1 眼发生虹膜色素脱失，与组 II 比较差异无统计学意义（ > 0.05）。