Long-term Therapeutic Outcome of Acute Primary Angle Closure in Japanese
Long-term Therapeutic Outcome of Acute Primary Angle Closure in Japanese
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DOI：
10.1007/s10384-007-0464-z
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发表时间：
2007-09
影响因子：
2.4
通讯作者：
A. Sawada;A. Aoyama;Tetsuya Yamamoto;N. Takatsuka
中科院分区：
文献类型：
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作者：
A. Sawada;A. Aoyama;Tetsuya Yamamoto;N. Takatsuka
PurposeTo探讨日本patients.MethodsWe急性原发性闭角型青光眼（APACG）和急性原发性闭角型青光眼（APAC）的长期临床过程回顾性分析了我们的记录，66个连续APAC或APACG眼睛观察1992年2月至2003年12月（平均随访，42.1个月）。在确诊后，所有患者都立即接受了类似的药物治疗，以阻止急性发作。随后，进行激光虹膜切开术或手术周边虹膜切除术和/或激光虹膜成形术。如果在最大可耐受的眼内扩张剂下眼压控制不佳，则进行小梁切除术，并使用抑制性丝裂霉素C（MMC）。结果激光治疗后，成功率（定义为眼压<21 mmHg，有或无药物治疗）为81.2% ± 6.2%。在小梁切除术的10只眼中，基于相同标准的成功概率为40.0% ± 29.7%。多变量分析显示，粘连性房角关闭的程度（P= 0.029）和慢性青光眼性视神经病变（P= 0.015）的预先存在显着影响需要随后的过滤surgery.ConclusionsWithout干预的过滤surgery，84.6%的眼睛与APAC或APACG保持IOP控制有或没有抗青光眼药物。然而，最终接受小梁切除术的APAC和APACG眼倾向于不可控的IOP，即使术中应用MMC。日本人APAC或APACG的严重程度可能受到潜在的蠕变性房角关闭的影响。Jpn J Ophthalmol 2007;51：353-359 ©日本眼科学会2007
PurposeTo investigate the long-term clinical course of acute primary angle closure (APAC) and acute primary angle-closure glaucoma (APACG) in Japanese patients.MethodsWe retrospectively reviewed our records of 66 consecutive APAC or APACG eyes observed between February 1992 and December 2003 (mean follow-up, 42.1 months). Immediately after the diagnosis, all patients had received similar medications to halt the acute attack. Subsequently, laser iridotomy or surgical peripheral iridectomy and/or laser iridoplasty were conducted. If intraocular pressure (IOP) control was poor under maximum tolerable ocular hypotensive agents, trabeculectomy with adjunctive mitomycin C (MMC) was undertaken.ResultsAfter laser therapy, the probability of success, defined as an IOP of <21 mmHg with or without medications, was 81.2% ± 6.2%. In the ten eyes that were trabeculectomized, the probability of success based on the same criterion was 40.0% ± 29.7%. Multivariate analysis revealed that the degree of synechial angle closure (P= 0.029) and the preexistence of chronic glaucomatous optic neuropathy (P= 0.015) significantly influenced the need for subsequent filtering surgery.ConclusionsWithout the intervention of filtering surgery, 84.6% of eyes with APAC or APACG maintained IOP control with or without antiglaucoma medications. However, APAC and APACG eyes that eventually received trabeculectomy were predisposed to an uncontrollable IOP, even with the intraoperative application of MMC. The severity of APAC or APACG in Japanese may be affected by an underlying creeping angle closure.Jpn J Ophthalmol2007;51:353–359 © Japanese Ophthalmological Society 2007