即刻氩激光周边虹膜成形术(ALPI)初始治疗白内障摘除前急性晶状体变形性闭角型青光眼(膨胀期白内障继发青光眼):一项初步研究

作     者：Tham C.C.Y Poon A.S.Y 张鹏 

出 版 物：《世界核心医学期刊文摘（眼科学分册）》 (Digest of the World Core Medical Journals:Ophthalmology)

年 卷 期：2005年第1卷第12期

页      面：46-47页

学科分类：1002[医学-临床医学] 100212[医学-眼科学] 10[医学] 

主　　题：ALPI 膨胀期白内障 白内障摘除 闭角型青光眼 继发青光眼 变形性 初始治疗 抗青光眼药物 阿托品滴眼液 噻吗心安 

摘      要：Purpose: To study the safety and efficacy of immediate argon laser peripheral iridoplasty (ALPI) as initial treatment of acute phacomorphic angle-closure (phacomorphic glaucoma) before cataract extraction. Methods: In all, 10 consecutive patients with acute phacomorphic angle-closure and intraocular pressure (IOP) ≥ 40 mmHg were recruited into the study. Each patient received topical atropine (1% ) and timolol (0.5% ), and immediate ALPI as initial treatment The IOP at 15, 30, 60, and 120 min, and then 1 day, after ALPI were documented by applanation tonometry. Systemic IOP-lowering drugs were only started if IOP remained above 40 mmHg at 2 h after ALPI. Cataract extraction was subsequently performed as definitive treatment. Results: In total, 10 patients (five male, five female), with a mean age± SD of 73.1± 10.3 years were recruited. Mean duration of symptomatic attack was 128± 232 h. After ALPI, the mean IOP was reduced from 56.1± 12.5 to 45.3± 14.5 mmHg at 15 min, 37.6± 7.5 mmHg at 30 min, 34.2± 9.7 mmHg at 60 min, 25.5± 8.7 mmHg at 120 min, and 13.6 ± 4.2 mmHg at 1 day. In one patient, systemic acetazolamide was administered, because the IOP remained above 40 mmHg at 2 h after ALPI. All 10 patients had uncomplicated cataract extraction performed within 4 days after ALPI. No complications from the laser procedure were encountered. Conclusion: ImmediateALPI, replacing systemic antiglaucomatous medications, appeared to be safe and effective as first-line treatment of acute phacomorphic angle-closure.