應用雷射對青光眼的治療　第二報：雷射虹膜穿孔直後眼壓上升之觀察及對策

Laser Therapy of Glaucoma. (Ⅱ) Observation of Intraocular Pressure Elevation after Iridotomy and Corticosteroid Pretreatment

洪伯廷(Por Tying Hung)

《中華民國眼科醫學會會刊》 25卷2期 (1986/05) Pp. 448-455

https://doi.org/10.30048/ACTASOS.198605.0082

摘要

本實驗係對125眼115名原發性隅角閉鎖性青光眼施行氬氣虹膜穿孔術後，眼壓變化的觀察。實驗分組包括（一）隅角是否已有黏連，期能闡明隅角病理的因素（二）術前三天前起施行類固醇點眼，期能防止其眼壓的升高。實驗結果顯示氬氣虹膜穿孔直後，一到二小時內有16眼(13%)，其眼壓升高10毫米汞柱以上，但是24小時後皆恢復正常。眼壓的升高與隅角之黏速與否無關，術前的類固醇點眼，未能防止其眼壓之升高。

並列摘要

In the past few years, argon laser iridotomy has demonstrated its safety and efficacy and has been widely accepted as the preferred procedure for relief of pupillary block in angle-closure glaucoma. However, the transient increased intraocular pressure immediately following the laser therapy is a serious complication especially for those chronic angle-closure glaucoma patients associated visual field defects. This complication may add to the potential for further visual field loss as in cases of post laser trabeculoplasty ocular pressure elevation in primary open angle glaucoma.
The present report includes studies on 125 eyes observed for intraocular pressure changs following the argon laser iridotomy procedure. We also divided cases into those with angle pathology of peripheral anterior synechia (76 eyes) and those without (49 eyes) in order to study the difference of pressure response. Corticosteroid topical pretreatment given to 66 eyes 3 days prior to the procedure was also compared with 59 eyes not receiving pretreatment. The argon laser procedure was performed by multiple sessions procedure as described by the author previously. The following are the conclusions reached in this experiment:
1. Of the 125 eyes, there were 16 eyes (l39) that demonstrated more than 10 mmHg elevation within two hours immediately following the laser procedure while 48 eyes (38%) revealed elevation of more than 5 mmHg. There were no statistical differences regarding intraocular pressure change and angle synechia pathology.
2. The intraocular pressure elevation were all transient phenomenon. All 125 eyes showed normal pressure within 24 hours following the laser procedure. However, it is recommendable to follow the intraocular pressure for three hours following the laser procedure. For those with risky elevation of pressure.
3. Pretreatment with corticosteroid topical eye drop prior to laser therapy does not alter the intraocular pressure elevation in the laser iridotomy.

並列關鍵字

Iridotomy ； IOP elevation ； Corticosteroid ； NTUH