Observation on the effect of anterior chamber puncture combined with laser peripheral iridectomy in the treatment of acute primary angle closure glaucoma
10.3760/cma.j.cn115455-20240516-00409
- VernacularTitle:前房穿刺术联合激光周边虹膜切除术治疗急性原发性闭角型青光眼的效果观察
- Author:
Yaming WANG
1
;
Wen ZHAO
;
Kai TANG
Author Information
1. 青岛市黄岛区中医医院眼科，青岛 266500
- Publication Type:Journal Article
- Keywords:
Glaucoma, angle-closure;
Anterior chamber puncture surgery;
Laser peripheral iridectomy;
Corneal edema;
Best corrected visual acuity
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(4):378-382
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the therapeutic effect of anterior chamber puncture combined with laser peripheral iridectomy (LPI) on patients with acute primary angle closure glaucoma (PACG).Methods:A total of 85 patients (85 eyes) with acute PACG treated in the Qingdao Huangdao District Traditional Chinese Medicine Hospital from January 2019 to December 2022 were selected and divided into the study group (43 cases, treated with anterior chamber puncture combined with LPI) and the control group (42 cases, treated with drug antihypertensive combined with LPI) by random number table method. The best corrected visual acuity, intraocular pressure, corneal edema grade, central anterior chamber depth, angle opening range and postoperative complications were compared between the two groups.Results:Before surgery, there were no statistical differences in the best corrected visual acuity and intraocular pressure between the two groups ( P>0.05), and at 3, 6 and 12 months after surgery, the best corrected visual acuity and intraocular pressure in the two groups were significantly lower than those before surgery, and the study group were lower than those in the control group: (0.41 ± 0.09) logMAR vs. (0.47 ± 0.10) logMAR, (0.26 ± 0.05) logMAR vs. (0.31 ± 0.06) logMAR, (0.30 ± 0.07) logMAR vs. (0.34 ± 0.08) logMAR; (14.3 ± 3.6) mmHg(1 mmHg = 0.133 kPa) vs. (16.5 ± 3.2) mmHg, (15.0 ± 3.9) mmHg vs. (17.6 ± 3.6) mmHg, (17.4 ± 3.5) mmHg vs. (20.0 ± 3.8) mmHg, there were statistical differences ( P<0.05). Before surgery, there were no statistical differences between the two groups in central anterior chamber depth and angle opening range ( P>0.05), and at 3, 6 and 12 months after surgery, the central anterior chamber depth and angle opening range were higher in the both groups and the study group were higher than those in the control group: (2.94 ± 0.46) mm vs. (2.72 ± 0.45) mm, (3.01 ± 0.50) mm vs. (2.89 ± 0.48) mm, (2.93 ± 0.44)mm vs. (2.81 ± 0.47) mm; (244.0 ± 26.0)° vs. (236.1 ± 29.5)°, (256.5 ± 27.4)° vs. (248.3 ± 30.3)°, (250.7 ± 29.0)° vs. (241.5 ± 25.4)°, there were statistical differences ( P<0.05). There was no significant difference in preoperative corneal edema grade between the two groups ( P>0.05), and the corneal edema grade in the study group was lower than that in the control group at 3 d after operation, there was statistical difference ( P<0.05). The complication rate was 4.65%(2/43) in the study group and 14.29% (6/42) in the control group, there was no statistical difference ( χ2 = 2.31, P>0.05). Conclusions:The combination of anterior chamber puncture and LPI surgery is beneficial for controlling intraocular pressure, improving vision, and restoring anterior chamber depth in PACG patients, and its clinical efficacy is certain.
