Ricardo J Cumba, Kundandeep S Nagi, Nicholas P Bell, Lauren S Blieden, Alice Z Chuang, Kimberly A Mankiewicz, Robert M Feldman
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引用次数: 17
摘要
目的。目的评价周围虹膜切开术(PI)对原发性闭角疑点(PACS)、慢性原发性闭角(CPAC)和慢性原发性闭角青光眼(CPACG)的初步治疗效果。患者和方法。纳入了79只视力大于20/50的PACS、CPAC或CPACG患者作为初始治疗的PI。既往有急性闭角发作、激光小梁成形术、手术或眼内注射的眼睛被排除在外。评估额外的治疗、青光眼的进展、眼压、视力和药物的数量。结果。平均随访时间为57.1±29.0个月(13.8 ~ 150.6个月)。68只眼(86.1%)接受了额外的药物、激光或手术治疗。40眼(50.6%)因视力下降行晶状体摘除。所有患者的平均10× logMAR视力评分从基线时的0.94±1.12显著下降到末次随访时的1.83±3.49 (N = 79, P = 0.0261)。结论。大多数因CPAC频谱接受PI的患者将需要额外的干预来降低IOP或改善视力。这表明,手术不仅要加深角度,而且要降低IOP,提高视力,这样可以避免进一步的干预。对实现所有3个目标的技术进行评估是必要的。
Clinical outcomes of peripheral iridotomy in patients with the spectrum of chronic primary angle closure.
Purpose. To evaluate outcomes of peripheral iridotomy (PI) for initial management of primary angle closure suspects (PACS), chronic primary angle closure (CPAC), and chronic primary angle closure glaucoma (CPACG). Patients and Methods. Seventy-nine eyes with PACS, CPAC, or CPACG and better than 20/50 visual acuity that underwent PI as initial management were included. Eyes with previous acute angle closure attacks, laser trabeculoplasties, surgeries, or intraocular injections were excluded. Additional treatments, glaucomatous progression, intraocular pressure, visual acuity, and the number of medications were evaluated. Results. The mean followup was 57.1 ± 29.0 months (range 13.8-150.6 months). Sixty-eight eyes (86.1%) underwent additional medical, laser, or surgical treatment. Forty eyes (50.6%) underwent lens extraction due to reduced visual acuity. The mean 10× logMAR visual acuity score for all patients significantly declined from 0.94 ± 1.12 at baseline to 1.83 ± 3.49 (N = 79, P = 0.0261) at the last followup. Conclusions. Most patients who undergo PI for CPAC spectrum will require additional intervention for either IOP lowering or improvement of visual acuity. This suggests that a procedure that not only deepens the angle but also lowers IOP and improves visual acuity would be desirable as further intervention could be avoided. Evaluation of techniques that achieve all 3 goals is warranted.