| 摘要
目的 分析180°氩激光周边虹膜成形术（ALPI）治疗原发性急性闭角型青光眼（PACG）的有效性和安全性。
方法 15例首次发作的36小时内的原发性急性闭角型青光眼（PACG），未予以药物抗青光眼治疗，采用局限性180°氩激光周边虹膜成形术（ALPI）治疗，观察治疗前后的视力、角膜水肿变化情况及眼压是否下降，以及房角改变情况。
结果 15 例患者ALPI术后眼压均下降，15’后平均下降16mmHg（下降率29.7%）, 30’后平均下降23.3mmHg（下降率42.3%）, 60’后平均下降31.2mmHg(下降率57.9%）, 90’后平均下降36.5mmHg（下降率67.8%）, 120’后眼压均正常。眼压下降后，角膜均由水肿变透明。治疗眼的房角均较对侧眼增宽。患者均能耐受治疗，未出现并发症。
结论 局限性180°氩激光周边虹膜成形术（ALPI）治疗首次发作的36小时内的原发性急性闭角型青光眼（PACG），既能迅速开放房角，降低眼压，体现激光治疗微创、精确、并发症少的优越性，又能避免全身用药的毒副作用，尤其适合于有全身合并症的患者，减少对患者的健康损害，成为另一种治疗PACG的行之有效的新方法。
A Clinical Analysis Of Limited Argon laser Peripheral Iridoplasty As Immediate Treatment For An Acute Attack Of Primary Angle Closure Glaucoma
Yu Min,Wang Xiaoli,Zeng Jian, Chen Xianghui, Fan Ping, Wang Ke,
Mianyang Central Hospital Sichuan Province China 621000
Purpose:To evaluate the efficacy and safety of limited (180°) Argon Laser Peripheral Iridoplasty (ALPI)for acute primary angle closure glaucoma(PACG).Methods:15 patients with PACG of duration of attack≤36h were recruited into the study. Each patient received immediate limited ALPI as primary treatment without the use of medications.We observed the change of the intraocular pressure(Iop),the risual accity,the corneal oedema and the anterior chamber angle.Results:The Iop of all patients was reduced.The mean Iop was decreased 16mmHg at 15min,23.3mmHg at 30min,31.2mmHg at 60min,36.5mmHg at 90min.The Iop of evergone was normal at 120min.The corneal oedema cleared after ALPI when the Iop was normal.The anterior chamber angle of the eye with ALPI was wider than that of the other eye .Everyone could endure the ALPI and we didn’t observed the complications. Conclusion:Immediate limited 180° ALPI appeared to be effective and safe in controlling the Iop in treating acute PACG with a duration of attack≤36h.
Keywords Acute angle closure glaucoma Laser peripheral iridoplasty
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