眼科

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氩激光周边虹膜成形术对急性闭角型青光眼急性发作期角膜内皮细胞的影响

李琦琰  牟大鹏  李航  卿国平   

  1. 100730首都医科大学附属北京同仁医院  北京同仁眼科中心 眼科学与视觉科学北京市重点实验室                
  • 收稿日期:2018-05-12 出版日期:2018-07-25 发布日期:2018-07-27
  • 通讯作者: 卿国平,Email:gptsing@126.com

Effect of argon laser peripheral iridoplasty on corneal endothelium in acute angle closure glaucoma 

LI Qi-yan, MOU Da-peng, LI Hang, QING Guo-ping.   

  1. Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Science Key Laboratory, Beijing 100730, China
  • Received:2018-05-12 Online:2018-07-25 Published:2018-07-27
  • Contact: QING Guo-ping, Email: gptsing@126.com

摘要:

目的 评价氩激光周边虹膜成形术(argon laser peripheral iridoplasty,ALPI)治疗急性闭角型青光眼(acute angle closure glaucoma,AACG)急性发作后对角膜内皮细胞数量的影响。设计 回顾性病例系列。研究对象 162例单眼AACG急性发作并成功接受药物治疗(药物组)或ALPI治疗(ALPI组)的患者。方法 回顾性分析了患者的性别、年龄分布、治疗前后眼压、抗青光眼药物种类、角膜内皮数量,比较了两组间发作眼治疗前后角膜内皮数量变化。主要指标 治疗前后角膜内皮数量、眼压水平、抗青光眼药物种类。结果 61例AACG患者急性发作后成功接受ALPI治疗,平均年龄(59.8±10.2)岁;发作眼治疗前眼压(44.7±4.1)mmHg;药物组101例,平均年龄(58.6±6.1)岁,发作眼治疗前眼压(45.3±4.8) mmHg。治疗后,ALPI组平均眼压(11±2.6)mmHg,角膜恢复透明后发作眼较对侧眼角膜内皮数量减少(1613±332)/mm2,药物组平均眼压(14.5 ±3.1)mmHg,角膜内皮平均减少(1321±290)/mm2,少于ALPI组(P=0.000)。结论 ALPI和药物成功治疗AACG后,ALPI所致角膜内皮数量减少甚于药物治疗。(眼科,2018, 27: 291-295)

关键词: 急性闭角型青光眼/治疗, 角膜内皮密度, 氩激光周边虹膜成形术

Abstract:

Objective To evaluate the effect of argon laser peripheral iridoplasty (ALPI) on corneal endothelium in the acute attack stage of acute angle closure glaucoma(AACG). Design Retrospective case series. Participants 162 patients with unilateral AACG successfully managed with either anti-glaucoma medication or ALPI. Methods Gender, age, pro-and post-treatment intraocular pressure (IOP), anti-glaucoma medication, corneal endothelial cell density of the patients were reviewed and analyzed statistically. Main outcome measures Loss of corneal endothelial cell, pro- and post-treatment IOP, anti-glaucoma medications of the effected eye. Results 61 cases received successful ALPI for the acute attack of AACG, with average age of 59.8±10.2 years old. The mean IOP of the effected eyes was 44.7±4.1 mmHg. In the medication group, 101 cases were included with average age of 58.6±6.1 years old. The mean IOP in the effected eyes was 45.3±4.8 mmHg. After treatment, the average IOP in ALPI group was 11±2.6 mmHg, in which the average loss of corneal endothelium was 1613±332/mm2. Mean IOP of treated AACG eyes in medication group was 14.5 ±3.1 mmHg,in which the corneal endothelial cell loss was 1321±290/mm2,which was significantly less than that of ALPI group(P=0.000). Conclusion Both ALPI and medication can arrest the acute attack of AACG, while the former may cause more corneal endothelial cell loss. (Ophthalmol CHN, 2018, 27: 291-295)

Key words: acute angle closure glaucoma/treatment, corneal endothelial cell density, argon laser peripheral iridoplasty