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[窄角型和开角型青光眼虹膜切除术的结果。一项回顾性研究]

[Results of iridectomy in narrow-angle and open-angle glaucoma. A retrospective study].

作者信息

Weder W, Zeidler M

出版信息

Klin Monbl Augenheilkd. 1983 Sep;183(3):159-65. doi: 10.1055/s-2008-1054894.

DOI:10.1055/s-2008-1054894
PMID:6645255
Abstract

Between 1970 and 1975 166 iridectomies were performed in cases of primary glaucoma. In the retrospective study reported here the authors analyzed the results with regard to the regulation of intraocular pressure (IOP) and loss of function. Follow-up examinations were performed (1) between 6 weeks and 6 months, (2) 12 months, (3) 1.5 to 2.5 years and (4) 3 to 4 years after surgery in patients whose IOP was not adequately regulated. Hypotonia was rare. Of the eyes with acute narrow-angle glaucoma with an open iridocorneal angle by definition, which underwent surgery for the first time, 30% had an IOP of more than 21 mm Hg with or without additional tension-lowering medication (20% between 22 and 24 mm Hg, 10% over 24 mm Hg). The results for eyes operated on for the second time were better because of the prophylactic iridectomies in this group. In one-third of the cases the iridocorneal angle was occluded; in two-thirds an open angle was found. An analysis revealed that regulation was better when the previous tension level had been high, while lower tension levels, of between 20 and 35 mm Hg, often remained elevated after surgery. Out of the total number of eyes operated on for the first time (narrow-angle and open-angle glaucoma) IOP was regulated by iridectomy alone in 54% after 1 year and in 33% after 2 years. With regard to the iridocorneal angle of these 33%, it was found that 50% of the cases of narrow-angle glaucoma were regulated without further medication, but only 20% of the open-angle cases.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

1970年至1975年间,对原发性青光眼患者实施了166例虹膜切除术。在本回顾性研究中,作者分析了眼压(IOP)调节及功能丧失方面的结果。对眼压调节不佳的患者在术后进行了随访检查:(1)术后6周和6个月之间;(2)术后12个月;(3)术后1.5至2.5年;(4)术后3至4年。低眼压情况罕见。对于首次接受手术、根据定义房角开放的急性闭角型青光眼患者,30%的患者眼压超过21 mmHg,无论是否使用其他降眼压药物(20%的患者眼压在22至24 mmHg之间,10%的患者眼压超过24 mmHg)。由于该组患者进行了预防性虹膜切除术,二次手术患者的结果更好。三分之一的病例房角闭塞;三分之二的病例房角开放。分析显示,术前眼压较高时调节效果更好,而术前眼压在20至35 mmHg之间的较低眼压水平,术后往往仍居高不下。在首次接受手术的所有患者(闭角型和开角型青光眼)中,1年后仅通过虹膜切除术眼压得到调节的患者占54%,2年后为33%。在这33%的患者中,就房角情况而言,发现50%的闭角型青光眼病例无需进一步用药眼压即得到调节,但开角型青光眼病例只有20%。(摘要截选至250词)

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