Efficacy of Laser Iridoplasty Combined with Nd∶YAG Laser on Angle-closure Glaucoma and Its Influence on Postoperative Visual Acuity Level and Angular Structure Changes
Objective To study the efficiency of argon laser peripheral iridoplasty(ALPI)combined with Nd∶YAG laser on angle-closure glaucoma(ACG)and the potential influence on postoperative visual acuity level and angular structure changes.Methods A retrospective analysis was performed on 114 patients(168 eyes,including 60 cases of unilateral disease and 54 cases of bilateral disease)with ACG in Baoji People's Hospital from July 2020 to July 2023.52 patients(80 eyes)from July 2020 to July 2021 were included in the control group,and 53 patients(88 eyes)from July 2021 to July 2023 were enrolled as observation groups.The control group was treated with anterior chamber puncture combined with Nd∶YAG laser,and the observation group was given ALPI combined with Nd∶YAG laser therapy.The chamber angle structure and aqueous system function indicators and corneal endothelial cell parametric variation before surgery and at 12 months after surgery.The best corrected visual acuity level,intraocular pressure status before surgery and at 1 month,4 months and 12 months after surgery were compared between the two groups,and the complications were recorded.Results At 1 month,4 months and 12 months after surgery,the intraocular pressure status in both groups was significantly decreased compared with that before surgery,and the decrease in the observation group was lower than that in the control group(P all＜0.05).The best corrected visual acuity level was significantly increased compared to before surgery,and the level was higher in the observation group(P all＜0.05).At 12 months after surgery,the anterior chamber depth,anterior chamber angle,Schlemm canal diameter and trabecular meshwork area were significantly increased in both groups than those before surgery,and the increases in observation group were greater than those in control group(P all＜0.05).The cell density(CD),minimum cell area(MIN),maximum cell area(MAX),average cell area(AVE),standard deviation of cell area(SD)and coefficient of variation(CV)were all significantly reduced compared to before surgery,except for CD,the observation group had higher levels than the control group(P all＜0.05).Conclusion ALPI combined with Nd∶YAG laser therapy can significantly control the intraocular pressure,significantly improve the best corrected visual acuity level and chamber angle structure and function.
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