A Study On The Treatment Of Acute Angle-closure Glaucoma By Kr Laser Compound Iridoplasty

ObjectiveTo discuss the safe distance of Kr laser focus to the corneal endotheliocyte by animal experiment; to evaluate the effect and safty for the treatment of acute angle-closure glaucoma (AACG) by Kr laser compound iridoplasty.Method(1) The safe distance of Ke laser focus to corneal endotheliocyte: The rabbits were divided into 3 sets randomly with the distance of Ke laser focus to the corneal endotheliocyte, which respectively were 0.6 mm s, 0.9 mm, 1.2 mm .Before and after applied with Kr laser(40mJ,80mJ,120mJ,160mJ) , The density of the corneal endotheliocyte were measured and then compared their variety.(2) The efficacy and safty for the treatment of acute angle-closure glaucoma by Kr laser compound iridoplasty: The 13 patients (13 eyes) of acute angle-closure glaucoma were treated by Kr laser compound iridoplasty.,IOP , the density of corneal endotheliocyte and the angle of anteror chamber were observed.Result (1) When the range from the corneal endotheliocyte to Ke laser focus exceeds 1.2mm, all groups didn't cause the loss of the corneal endotheliocyte obviously.(2) The mean IOPs reduced from (52.4±9.3) mmHg (1mmHg=0.133 Kpa) preoperatively to (25.7±8.4) mmHg, (19.6±12.3) mmHg and (19.1±6.3) mmHg at 0.5h,1h,1.5h respectively after the treatment., decreasing by 51.4%,60.6%,64.6% respectively. The mean cornea endothelium cell density before and 1w after treatment were 2721±287个/ mm2 and 2695±312个mm2 ,and there was no statistical difference (p>0.05) .UBM showed that the angle open distance of 500μm (AOD500) were (43±9)μm and (144±17)μm at preoperation and 1d after treatment respectively. There was significant statistical difference (p<0.05). Trabecular Iris Angle (TIA) were (4.52±1.12) degree and(14.35±1.72) degree at preoperation and 1d after treatment respectively (p<0.05). , Iris Lens Angle (ILA) were(18.86±1.75) degree ,(14.41±1.76) degree, and (16.85±2.93) degree in preoperation, 1d and 3m after the treatment, respectively. (P<0.05).Conclusion1.2 mm is the safe distance of Kr laser focus to corneal endotheliocyte. Kr laser compound iridoplasty can treat AACG effectively and safely by relieving some angle closure, lowing IOP, and not lost the corneal endotheliocyte obviously.