Ritch R
Am J Ophthalmol. 1982 Aug;94(2):197-204. doi: 10.1016/0002-9394(82)90075-7.
Seven patients with medically unresponsive attacks of angle-closure glaucoma were successfully treated with the argon laser. Three methods may be used either singly or in combination to cut short an attack: (1) peripheral iridoplasty, (2) pupilloplasty, and (3) laser iridectomy. Laser treatment is preferable to and safer than intraocular iridectomy in such cases. Pilocarpine, which increases the axial length of the lens and shallows the anterior chamber, may worsen angle closure by increasing the pupillary block. An enlarged lens or forward movement of the lens may be a significant factor in medically unresponsive attacks. The routine use of copious amounts of pilocarpine should be avoided in treating angle-closure glaucoma.
7例药物治疗无效的闭角型青光眼发作患者经氩激光治疗成功。可单独或联合使用三种方法来缩短发作：（1）周边虹膜成形术，（2）瞳孔成形术，（3）激光虹膜切除术。在此类病例中，激光治疗比眼内虹膜切除术更可取且更安全。毛果芸香碱会增加晶状体的眼轴长度并使前房变浅，可能通过增加瞳孔阻滞而加重房角关闭。晶状体增大或晶状体前移可能是药物治疗无效发作的一个重要因素。在治疗闭角型青光眼时应避免常规大量使用毛果芸香碱。
