Yamamoto T, Shirato S, Kitazawa Y
Jpn J Ophthalmol. 1985;29(1):1-12.
Argon laser iridotomy was performed in a total of 140 eyes of 104 patients with primary angle-closure glaucoma. A total of 69 eyes were treated by the long-burn technique and followed for an average period of 2.7 years; 71 eyes were treated by the short-burn technique and followed for an average period of 1.7 years. The effects on the IOP control and various factors of glaucoma were similar between both techniques, and the results of iridotomy were analyzed for all eyes. The IOP was controlled at or lower than 20 mmHg in 29% without medication, in 52% with reduced or the same medication as the preoperative treatments, and in 13% with increased medication. However, in 6% the IOP could not be controlled. The incidence of IOP control by iridotomy alone was significantly higher in eyes with peripheral anterior synechia (PAS) less than half the angle circumference than in eyes with more extensive PAS. Visual acuity loss occurred in 51%, and the loss by more than three lines of the acuity chart was seen in 19%; the visual loss was thought to be due to cataract progression or development. No significant differences were found in the visual field, cup-disk ratio, the extent of PAS or tonographic C-value before and after iridotomy. The IOP control and visual acuity loss were comparable with those seen after surgical iridectomy. Because of the absence of significant complications and ease of performance, iridotomy may replace surgical iridectomy in the treatment of angle-closure glaucoma.
对104例原发性闭角型青光眼患者的140只眼睛进行了氩激光虹膜切开术。其中69只眼睛采用长脉冲技术治疗，平均随访2.7年；71只眼睛采用短脉冲技术治疗，平均随访1.7年。两种技术对眼压控制和青光眼各种因素的影响相似，对所有眼睛的虹膜切开术结果进行了分析。眼压在未用药时控制在20 mmHg或更低的占29%，用药减少或与术前治疗相同的占52%，用药增加的占13%。然而，有6%的眼压无法控制。虹膜切开术单独控制眼压的发生率在周边前粘连（PAS）小于房角圆周一半的眼中显著高于PAS范围更广的眼。视力下降的发生率为51%，视力表下降超过三行的占19%；视力下降被认为是由于白内障进展或发展所致。虹膜切开术前和术后在视野、杯盘比、PAS范围或眼压描记C值方面未发现显著差异。眼压控制和视力下降情况与手术虹膜切除术相当。由于没有明显并发症且操作简便，虹膜切开术在闭角型青光眼治疗中可能会取代手术虹膜切除术。
