ABSTRACT
@#AIM: To investigate the clinical effect of combined laser peripheral iridectomy for primary angle-closure glaucoma.<p>METHODS: A total of 82 eyes were included in 82 patients with primary angle-closure glaucoma who visited our hospital from August 2015 to October 2017. They were randomly divided into two groups. Patients in the simple laser group were performed Nd:YAG laser only. In the combined laser group, 532 semiconductor laser combined with Nd: YAG laser were used for laser peripheral iridectomy. Intraocular pressure(IOP)was measured preoperative and postoperative. Laser energy was recorded. Iridemia were observed.<p>RESULTS: Postoperative IOP increased significantly in the simple laser group compared with the combined laser group, and the differences between the two groups 1h, 1d and 1wk after operation were statistical significances(<i>P</i><0.01). The IOP of the two groups was basically restored to the preoperative level at 1mo postoperatively. The success rate of single laser surgery was significantly lower than that of combined laser surgery(73% <i>vs </i>100%, <i>P</i><0.05). The total energy of Nd:YAG laser was significantly higher than that of the combined laser group(40.16±13.43mJ <i>vs</i> 23.23±6.70mJ, <i>P</i><0.05). There was no significant difference in intraoperative iris bleeding rate between the two groups(33% <i>vs</i> 26%, <i>P</i>>0.05).<p>CONCLUSION: Totally 532 semiconductor laser combined with Nd: YAG laser for peripheral iridectomy has a high rate of penetration, especially for patients without iris recess. It can significantly decreases laser energy, reduces the difficulty of laser operation and relieves intraocular inflammation.
ABSTRACT
AIM:To observe related biological parameters of 3 minutes dark-room provocative test in patients with laser peripheral iridectomy(LPI) in the fellow eyes of acute primary angle-closure (APAC) by ultrasound biomicroscopy (UBM).To explore the risk factors in primary angle closure suspect(PACS) patients with progressive angle closure after LPI.METHODS: Seventy-eight eyes of APAC patients without peripheral anterior synechia were selected.Each eye underwent 3 minutes dark-room provocative test after LPI.Anterior segment parameters, including anterior chamber depth (ACD), anterior chamber angle open distance500 (AOD500), peripheral iris thickness (PIT), iris convex (IC), the position of iris insertion and trabecular-ciliary process distance (TCPD), and the number of positional angle closure(NPAC) were observed and analyzed by statistic methods.RESULTS:Patients with APAC were examined by UBM after LPI and 26 eyes(33%) occurs at least one positional angle closure,19 eyes(24%)were positive in 3 minutes dark-room provocative test among them.It occurs a positive relationship between the elevation intraocular pressure and the number of positional angle closure in dark-room provocative test(r=0.84, P<0.01).AOD500, IT and IC were significantly changed from normal light to darkroom between positional angle closure positive group and positional angle closure negative group(all P<0.01).In single factor analysis, AOD500(P=0.003), IT(P=0.012), IC(P=0.043), TPCD(P=0.015), the position of iris insertion(P=0.024) were correlative factors of positive results.In multiple-factor analysis, only IT(P=0.011), TPCD(P=0.009), iris root attachment points(P=0.02) were independent risk factors of positive results.CONCLUSION:A certain proportion of patients with PACS after LPI appeared positional angle closure in a dark room.Peripheral iris hypertrophy, anterior displacement of the ciliary body and iris root attachment points are vital risk factors.Long-term follow-up study and intervention treatment are required in these patients after LPI.
ABSTRACT
AIM: To investigate the effect and safety of laser peripheral iridoplasty combined with iridectomy in the unmanageable acute angle - closure glaucoma by medication. METHODS:Totally 19 cases (21 eyes) with acute angle-closure glaucoma, including 15 cases ( 17 eyes ) with primary glaucoma and 4 cases (4 eyes) with intumescent cataract - induced glaucoma, were recruited into the study. The intraocular pressure ( IOP ) of all cases were still >21mmHg after 24h drug treatment, and then were treated by laser peripheral iridoplasty combined with iridectomy. The visual accurity, IOP, cornea, peripheral anterior chamber depth, anterior chamber angle and complications were observed at 24h after the surgery. RESULTS:The mean IOP of all cases was reduced from 53. 09±11. 01mmHg before the surgery to 14. 98±4. 21mmHg at 24h after the treatment, with significant statistical difference ( P CONCLUSION: Laser peripheral iridoplasty combined with iridectomy is an effective and safe method for the treatment of the unmanageable acute angle - closure glaucoma by medication.