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目的观察和评价非穿透小梁手术(NPTS)后YAG激光房角穿孔术(LGP)的降眼压效果及并发症。设计回顾性病例系列。研究对象 NPTS术后行LGP的23例(27眼)青光眼患者。方法对NPTS术后早期高眼压的23例(27眼)青光眼患者行LGP,观察术眼LGP术前、术后早期和术后远期的眼压,及术后并发症。主要指标眼压,并发症。结果 NPTS术后平均(11．4± 15.6)周行LGP,LGP后平均随访(15．87±14．68)周。LGP术前平均眼压为(19．7±5．09)mmHg,术后早期平均眼压为(10．8±3．7) mmHg(P=0．011)。平均降眼压幅度为8．9mmHg(45．2％)。其中随访时间在4个月以上者16眼,术前平均眼压(19．2±3．9)mmHg,术后早期平均眼压(11.9±3．6)mmHg,术后中远期平均眼压(15．7±2．9)mmHg(P=0．000)。术后远期眼压较术前下降3．5mmHg (17．8％)。并发症有虹膜嵌顿、术后低眼压、虹膜周边前粘连等。结论 LGP是NPTS术的有效补充,它提高了NPTS术的远期手术成功率,是一种安全有效的治疗措施。
Objective To observe and evaluate the intraocular pressure reduction (IOP) and complications of YGP laser angle posterior penetrating (LGP) after non-penetrating trabecular surgery (NPTS). Design retrospective case series. Twenty-three patients (27 eyes) with glaucoma underwent NPTS postoperative LGP. Methods Twenty-three patients (27 eyes) with glaucoma who had elevated intraocular pressure (IOP) after NPTS underwent LGP. The intraocular pressure (IOP) before and after surgery, and postoperative complications were observed. The main indicators of intraocular pressure, complications. Results The average postoperative NPTS (11.4 ± 15.6) weeks LGP, LGP average follow-up (15.87 ± 14.68) weeks. The average intraocular pressure (IOP) before LGP was (19.7 ± 5.09) mmHg and the average IOP after operation was (10.8 ± 3.7) mmHg (P = 0.011). The average IOP reduction was 8.9 mmHg (45.2%). The mean intraocular pressure (19.2 ± 3.9) mmHg, the average postoperative IOP (11.9 ± 3.6) mmHg, the average postoperative long-term Pressure (15.7 ± 2.9) mmHg (P = 0.000). Postoperative long-term intraocular pressure decreased 3.5mmHg (17.8%) compared with preoperative. Complications of iris incarceration, postoperative low intraocular pressure, the iris before the adhesion and so on. Conclusion LGP is an effective supplement to NPTS. It improves the success rate of long-term surgery of NPTS and is a safe and effective treatment.