摘要目的 观察YAG激光虹膜周边切开术联合非穿透性小梁切除术(NPDS)治疗单纯瞳孔阻滞型闭角型青光眼的疗效.方法 对2002年1月至2004年10月收治的21例(35只眼)单纯瞳孔阻滞型闭角型青光眼进行YAG激光虹膜周边切开术联合非穿透性小梁切除术,分析手术前后眼压的差异及术后各个随访期的手术成功率.随访期10～36月,平均(18.77±10.47)月.结果 术前平均眼压(25.57±4.92)mmHg,术后3月、6月、12月、24月和36月的眼压分别为(13.34±4.18)mmHg、(14.49±2.83)mmHg、(14.92±4.57)mmHg、(16.77±3.45)mmHg、(17.32±4.17)mmHg.术后3月、6月、12月、24月和36月的完全成功率分别为81.2%、78.1%、73.3%、69.0%、66.1%;部分成功率分别为82.4%、80.9%、74.7%、72.7%、70.1%.并发症有:微穿透6例,前房出血4例,低眼压3例,脉络膜脱离2例.结论 YAG激光虹膜周边切开术联合NPDS可作为治疗部分类犁的闭角型青光眼是安全有效地手术方式.

abstractsObjective To asses the result of nonpenetrating deep selerectomy with YAG laser iridotomy as surgical treatment of the pure papillary block primary angle closure glaucoma.Methods Thirty-five eyes with pure papillary block primary angle closure glaucoma were treated by YAG laser iridotomy and NPDS in succession.The main outcome measure was postoperative intraocular pressure (IOP)with an average follow-up of 18.77±10.47months(range 10-36).Success rateWasdetermined3,6,12,24,36months after the procedure.Results Mean preoperative IOP was 25.57±4.92 mmHg.Mean postoperative IOP was 13.34±4.18 mmHg at 3 months,14.49±2.83 mmHg at 6 months,14.92±4.57 mmHg at 12 months,16.77±3.45mmHg at 24 months,17.32±4.17 mmHg at 36 months.At the end offellow-up,complete SUCCESS rate was 66.1%and relative SUCCESS rate was 70.1%.Complications were micro-perforations in 6 eyes(17.14%),byphema in 2 eyes(5.57%),choroidal detachment in 2 eyes(5.57%).No cases ofendophthalmitis or shallow anterior chamber were found.Conclusions NPDS with YAG laser iridotomy appears to be an effective and safe filtering procedure in pure papillary block primary angle closure glaucoma with the advantage of having fewer complications.