Büchner M, Gloor B, Robert Y
Klin Monbl Augenheilkd. 1986 Jun;188(6):565-7. doi: 10.1055/s-2008-1050716.
Of 132 patients who had undergone Nd-YAG laser iridotomy, 70 were randomly selected for follow-up examinations. Nd-YAG laser iridotomies were subsequently performed on 124 eyes (of these 70 patients), 12 for acute angle-closure glaucoma, 19 fellow eyes of those which had angle-closure glaucoma, 70 for chronic angle-closure glaucoma, and 23 eyes with increasingly narrow chamber angle under miotic therapy. The follow-up period ranged from 1 to 25 months (median = 9 months). Eighty-seven percent of the iridotomies remained visibly open. Of 12 acute glaucomas, 10 were successfully treated, whereas only 2 required a basal iridectomy. In the large group of 106 eyes with a "narrow angle condition," a significant pressure reduction from 20.9 +/- 5.8 to 16.7 +/- 3.4 mm Hg and a significant enlargement of the chamber angle resulted. Since fistulizing procedures involve a risk of malignant glaucoma, Nd-YAG laser iridotomy, which this investigation showed to be risk-free, is the initial procedure of choice in narrow-angle conditions, especially subacute and chronic angle-closure glaucoma, in order to alleviate the angle-closure component in such angle-closure situations, to diagnose its contribution to peak IOP, and to facilitate argon laser trabeculoplasty when needed.
在132例行Nd-YAG激光虹膜切开术的患者中,随机选取70例进行随访检查。随后对这70例患者的124只眼进行了Nd-YAG激光虹膜切开术,其中12只为急性闭角型青光眼,19只为闭角型青光眼患者的对侧眼,70只为慢性闭角型青光眼,23只为在缩瞳治疗下房角逐渐变窄的眼。随访时间为1至25个月(中位数=9个月)。87%的虹膜切开术仍保持明显开放。在12例急性青光眼患者中,10例成功治愈,只有2例需要行周边虹膜切除术。在106只患有“窄角情况”的大组眼中,眼压从20.9±5.8显著降低至16.7±3.4 mmHg,房角显著增宽。由于造瘘手术存在恶性青光眼的风险,本研究表明Nd-YAG激光虹膜切开术无风险,是窄角情况尤其是亚急性和慢性闭角型青光眼的首选初始手术,以缓解此类闭角情况下的房角关闭因素,诊断其对眼压峰值的影响,并在需要时便于进行氩激光小梁成形术。