原发性慢性闭角型青光眼两种治疗模式临床疗效比较.docVIP

原发性慢性闭角型青光眼两种治疗模式临床疗效比较 　　[摘要] 目的 评估原发性慢性闭角型青光眼患者SMS治疗模式（“手术-药物-二次手术”）和LMS治疗模式（“激光周边虹膜切开术-药物-手术”）的临床疗效。方法 整群连续选取2013年1月―2014年12月在该院就诊的原发性慢性闭角型青光眼患者312例原发性慢性闭角型青光眼患者（312眼），随机分为两组：A组166眼行SMS治疗模式，B 组146眼行LMS治疗模式。随访12个月，比较两种治疗模式下眼压、杯/盘比值及视野的变化情况。结果 首次小梁切除术后6个月眼压控制成功率为84.9%，12个月时为80.1%；而激光周边虹膜切开术后6个月的眼压控制成功率为27.4%， 12个月时为17.1%。SMS治疗模式组和LMS模式组的二次手术率分别为10.2%和42.5%，两组比较差异有统计学意义（P0.05）。 结论 SMS模式和LMS治疗模式治疗原发性慢性闭角型青光眼1年期随访在控制视野及视神经进展方面效果相似，但从控制眼压方面SMS治疗模式的二次手术率明显低于LMS模式。 　　[关键词] 原发性慢性闭角型青光眼；激光周边虹膜切开术；小梁切除术；药物 　　[中图分类号] R775.2 [文献标识码] A [文章编号] 1674-0742（2017）08（a）-0098-05 　　[Abstracts] Objective This paper tries to assess the therapeutic efficacy of primary chronic angle-closure glaucoma between treatment mode “surgery-medication-surgery， SMS” and “LPI-medication-surgery， LMS”. Methods 312 patients with primary chronic angle-closure glaucoma treated in this hospital from January 2013 to December 2014 were group selected continuously and randomly divided into two groups. The Group A included 166 participants （166 eyes） was treated with SMS mode， and Group B included 146 participants （146 eyes） was treated with LMS mode. After 12 months of follow-up observation， the intraocular pressure， cup to disc ratio and field of vision in the two treatment modes were compared. Results The success rate of controlled IOP was 84.9% at 6 months after the first trabeculectomy， follow-up to 12 months was 80.1%. However， the success rate of intraocular pressure control was just 27.4% at 6 months after the laser peripheral iridotomy， follow-up to 12 months was 17.1%. The secondary surgical rates of the SMS treatment model group and the LMS model group were 10.2% and 42.5%， the difference were statistically significant. However， the cup to disc ratio and field of vision were of no statistical significance between two groups. Conclusion SMS and LMS mode had the same therapeutic efficacy in controlling visual field and the progress of optic nerve fiber layer among an one-year fellow-up in PCACG p