原发性前房角关闭眼在施行激光周边虹膜切除术后前房角关闭的发生率和发病机制的研究
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摘要
目的:了解原发性前房角关闭(primary angle closure,PAC)眼在施行预防性激光周边虹膜切除术(laser peripheral iridotomy,LPI)后前房角关闭的发生率,并通过比较PAC眼施行LPI后前房角关闭较轻者与较重者之间、PAC眼与正常前房深度眼之间的一些前房和前房角结构的参数,探讨PAC眼施行LPI后前房角关闭的可能机制。
对象和方法:(1)应用前瞻性干预性系列病例研究。对39名来自北京协和医院眼科门诊就诊的PAC患者施行LPI,并比较术前和术后两周的暗室下超声活体显微镜(ultrasound biomicroscopy,UBM)图像中获得的前房和前房角参数,包括中央前房深度(anterior chamber depth,ACD),附着性前房角关闭(iridotrabecularcontact,ITC)的范围,前房角开放距离(angle opening distance,AOD),小梁网-睫状突距离(trabecular-ciliary process distance,TCPD),周边部虹膜厚度(irisdistance,ID),虹膜-睫状突接触(iris-ciliary process contact,ICPC)的发生率,巩膜突-睫状突距离(sclera spur-ciliary process distance,SSCPD),小梁网-睫状突角(trabecular-ciliary process angle,TCPA)。(2)应用病例对照研究。将上述39只PAC眼,按LPI后前房角关闭的严重程度分为重度组(前房角关闭钟点数＞3钟点位,23眼)和轻度组(前房角关闭钟点数≤3钟点位,16眼)。比较PAC眼LPI后前房角关闭轻度组、重度组和正常前房深度组(20眼)三组之间的UBM前房及前房角参数,包括ACD、ID、TCPD、TCPA和SSCPD。
结果:(1)79.49%(31/39)的PAC眼在LPI后前房角有不同程度的增宽。87.18%(34/39)的PAC眼在LPI后暗室下UBM检查仍有≥1个钟点位的附着性前房角关闭。(2)在正常前房深度组、PAC眼LPI后前房角关闭轻度组和重度组之间的比较中,TCPD和TCPA呈递减趋势,组间差异具有统计学意义(P＜0.0001);ACD在正常前房深度组明显大于两组PAC眼(P＜0.0001),但是PAC眼两组之间的差异无统计学意义(P=0.7170);ID和SSCPD在三组间的差异无统计学意义(P＞0.05)。PAC眼LPI后前房角关闭钟点位数与TCPD和TCPA的相关系数分别为-0.4312(P=0.0069)和-0.3958(P=0.0126)。
结论:PAC眼LPI后的前房角关闭发生率极高。睫状突前位是导致PAC眼LPI后的前房角关闭的主要原因。
Purpose: To evaluate the prevalence of angle closure in eyes with primary angle closure (PAC) after laser peripheral iridotomy (LPI) and to determine the pathogenesis of this condition by comparing the anterior chamber and angle parameters among PAC eyes with severe angle closure after LPI, PAC eyes with mild angle closure after LPI and normal subjects.
Participants and Methods: (1) Based on the principle of prospective intervention case series study, prophylactic LPI was performed in 39 patients with PAC in the Department of Ophthalmology at Peking Union Medical College Hospital. Ultrasound biomicroscopy (UBM) examination was carried out before and 2 weeks after LPI in these eyes. One randomly selected eye of each subject was measured. UBM parameters before LPI were compared with those after LPI, including iridotrabecular contact (ITC), iris-ciliary process contact (ICPC), angle opening distance (AOD), trabecular-ciliary process distance (TCPD), iris distance (ID), scleral spur-ciliary process distance (SSCPD) and trabecular-ciliary process angle (TCPA). (2) The PAC eyes mentioned above were classified into two groups according to the severity of angle closure after LPI, severe one ( angle closure range after LPI≥4 clock positions, 23 eyes)and mild one ( angle closure range after LPI≤3 clock positions, 16 eyes). Based on the principle of case control study, UBM parameters of the two PAC groups after LPI were compared with those of the group with normal anterior chamber depth (20 eyes), including ACD, ID, TCPD, TCPA, SSCPD.
Results: (1) 79.49% (31/39) PAC eyes had wider angles after LPI. However, the proportion of eyes with UBM-identified ITC in≥1 clock position after LPI was 87.18% (34/39). (2) Among the three groups mentioned above, TCPD and TCPA were significantly smaller in eyes with severe angle closure after LPI compared to those with mild angle closure after LPI as well as the normal ones (P=0.0001). ACD was significantly smaller in eyes with PAC than eyes with normal anterior chamber (P<0.0001), however, there was no significant difference in ACD within PAC eyes. There were no significant differences among the three groups in ID and SSCPD. The correlation coefficient between angle closure range after LPI and TCPD was -0.4312 (P=0.0069) and between angle closure range after LPI and TCPA was -0.3958 (P=0.0126).
Conclusions: Angle closure was common in PAC eyes after LPI. Anteriorly positioned ciliary process played a key role in the pathogenesis of angle closure after LPI in PAC eyes.
对象和方法:(1)应用前瞻性干预性系列病例研究。对39名来自北京协和医院眼科门诊就诊的PAC患者施行LPI,并比较术前和术后两周的暗室下超声活体显微镜(ultrasound biomicroscopy,UBM)图像中获得的前房和前房角参数,包括中央前房深度(anterior chamber depth,ACD),附着性前房角关闭(iridotrabecularcontact,ITC)的范围,前房角开放距离(angle opening distance,AOD),小梁网-睫状突距离(trabecular-ciliary process distance,TCPD),周边部虹膜厚度(irisdistance,ID),虹膜-睫状突接触(iris-ciliary process contact,ICPC)的发生率,巩膜突-睫状突距离(sclera spur-ciliary process distance,SSCPD),小梁网-睫状突角(trabecular-ciliary process angle,TCPA)。(2)应用病例对照研究。将上述39只PAC眼,按LPI后前房角关闭的严重程度分为重度组(前房角关闭钟点数＞3钟点位,23眼)和轻度组(前房角关闭钟点数≤3钟点位,16眼)。比较PAC眼LPI后前房角关闭轻度组、重度组和正常前房深度组(20眼)三组之间的UBM前房及前房角参数,包括ACD、ID、TCPD、TCPA和SSCPD。
结果:(1)79.49%(31/39)的PAC眼在LPI后前房角有不同程度的增宽。87.18%(34/39)的PAC眼在LPI后暗室下UBM检查仍有≥1个钟点位的附着性前房角关闭。(2)在正常前房深度组、PAC眼LPI后前房角关闭轻度组和重度组之间的比较中,TCPD和TCPA呈递减趋势,组间差异具有统计学意义(P＜0.0001);ACD在正常前房深度组明显大于两组PAC眼(P＜0.0001),但是PAC眼两组之间的差异无统计学意义(P=0.7170);ID和SSCPD在三组间的差异无统计学意义(P＞0.05)。PAC眼LPI后前房角关闭钟点位数与TCPD和TCPA的相关系数分别为-0.4312(P=0.0069)和-0.3958(P=0.0126)。
结论:PAC眼LPI后的前房角关闭发生率极高。睫状突前位是导致PAC眼LPI后的前房角关闭的主要原因。
Purpose: To evaluate the prevalence of angle closure in eyes with primary angle closure (PAC) after laser peripheral iridotomy (LPI) and to determine the pathogenesis of this condition by comparing the anterior chamber and angle parameters among PAC eyes with severe angle closure after LPI, PAC eyes with mild angle closure after LPI and normal subjects.
Participants and Methods: (1) Based on the principle of prospective intervention case series study, prophylactic LPI was performed in 39 patients with PAC in the Department of Ophthalmology at Peking Union Medical College Hospital. Ultrasound biomicroscopy (UBM) examination was carried out before and 2 weeks after LPI in these eyes. One randomly selected eye of each subject was measured. UBM parameters before LPI were compared with those after LPI, including iridotrabecular contact (ITC), iris-ciliary process contact (ICPC), angle opening distance (AOD), trabecular-ciliary process distance (TCPD), iris distance (ID), scleral spur-ciliary process distance (SSCPD) and trabecular-ciliary process angle (TCPA). (2) The PAC eyes mentioned above were classified into two groups according to the severity of angle closure after LPI, severe one ( angle closure range after LPI≥4 clock positions, 23 eyes)and mild one ( angle closure range after LPI≤3 clock positions, 16 eyes). Based on the principle of case control study, UBM parameters of the two PAC groups after LPI were compared with those of the group with normal anterior chamber depth (20 eyes), including ACD, ID, TCPD, TCPA, SSCPD.
Results: (1) 79.49% (31/39) PAC eyes had wider angles after LPI. However, the proportion of eyes with UBM-identified ITC in≥1 clock position after LPI was 87.18% (34/39). (2) Among the three groups mentioned above, TCPD and TCPA were significantly smaller in eyes with severe angle closure after LPI compared to those with mild angle closure after LPI as well as the normal ones (P=0.0001). ACD was significantly smaller in eyes with PAC than eyes with normal anterior chamber (P<0.0001), however, there was no significant difference in ACD within PAC eyes. There were no significant differences among the three groups in ID and SSCPD. The correlation coefficient between angle closure range after LPI and TCPD was -0.4312 (P=0.0069) and between angle closure range after LPI and TCPA was -0.3958 (P=0.0126).
Conclusions: Angle closure was common in PAC eyes after LPI. Anteriorly positioned ciliary process played a key role in the pathogenesis of angle closure after LPI in PAC eyes.
引文
1.美国眼科学会(赵家良等译).眼科临床指南.北京:人民卫生出版社.2006:122-143.
2.Gazzard G,Friedman DS,Devereux JG,et al.A prospective ultrasound biomicroscopy evaluation of changes in anterior segment morphology after laser iridotomy in Asian eyes.Ophthalmology.2003;110(3):630-8.
3.Jin JC,Anderson DR.The effect of iridotomy on iris contour.Am J Ophthalmol 1990;110:260-3.
4.He M,Friedman DS,Ge J,et al.Laser peripheral iridotomy in eyes with narrow drainage angles:ultrasound biomicroscopy outcomes.The Liwan Eye Study.Ophthalmology.2007;114(8):1513-9.
5.Choi JS,Kim YY.Progression of peripheral anterior synechiae after laser iridotomy.Am J Ophthalmol.2005;140(6):1125-7.
6.Aung T,Ang LP,Chan SP,et al.Acute primary angle-closure:long-term intraocular pressure outcome in Asian eyes.Am J Ophthalmol.2001;131(1):7-12.
7.Garudadri CS,Chelerkar V,Nutheti R.An Ultrasound Biomicroscopic Study of the Anterior Segment in Indian Eyes with Primary Angle-Closure Glaucoma.J Glaucoma.2002;11(6):502-7.
8.Tello C,Liebmann J,Potash SD,et al.Measurement of ultrasound biomicroscopic images:intraobserver and interobserver reliability.Invest Ophthalmol Vis Sci 1994;35:3549-52.
9.Spaeth GL,Azuara-Blanco A,Araujo SV,et al.Intraobserver and interobserver agreement in evaluating the anterior chamber angle configuration by ultrasound biomicroscopy.J Glaucoma 1997;6:13-7.
10.赵家良,睢瑞芳,贾丽君等.北京市顺义县50岁及以上人群中青光眼患病率和正常眼眼压的调查.中华眼科杂志,2002;38:355-9.
11.王宁利,欧阳洁,周文炳等.中国人闭角型青光眼房角关闭发病机制的研究.中华眼科杂志.2000;36(1):46-51.
12. He M, Foster PJ, Johnson GJ, et al.. Angle-closure glaucoma in East Asian and European people. Different diseases? Eye. 2006; 20(1):3-12.
13. American Academy of Ophthalmology. Laser peripheral iridotomy for pupillary-block glaucoma. Ophthalmology 1994; 101:1749-58.
14. Nolan WP, Foster PJ, Devereux JG, et al. YAG laser iridotomy treatment for primary angle closure in east Asian eyes. Br J Ophthalmol 2000;84:1255-9.
15. Ritch R. Plateau iris is caused by abnormally positioned ciliary processes. J Glaucoma 1992; 1:23-26.
16. Pavlin CJ, Ritch R, Foster FS. Ultrasound biomicroscopy in plateau iris syndrome. Am J Ophthalmol 1992;113:390-5.
17. Pavlin CJ, Foster FS. Plateau iris syndrome: changes in angle opening associated with dark, light and pilocarpine administration. Am J Ophthalmol 1992; 128:288—91.
1.美国眼科学会(赵家良等译).眼科临床指南.北京:人民卫生出版社.2006:122-143.
2.赵家良,睢瑞芳,贾丽君等.北京市顺义县50岁及以上人群中青光眼患病率和正常眼眼压的调查.中华眼科杂志,2002;38:355-9.
3.葛坚,赵家良,崔浩.眼科学.北京:人民卫生出版社.2005:249-54.
4.Foster PJ,Buhrmann R,Quigley HA,Johnson GJ.The definition and classification of glaucoma in prevalence survey.Br J Ophthalmol.2002;86(2):238-42.
5.He M,Foster PJ,Johnson GJ,Khaw PT.Angle-closure glaucoma in East Asian and European people.Different diseases.Eye.2006;20(1):3-12.
6.Dhillon B,Chew PT,Lim ASM.Field loss in primary angle-closure glaucoma.Asia-Pac J ophthalmology 1990;2:85-87.
7.Douglas GR,Drance SM,Schulzer M.The visual field and nerve head in angle-closure glaucoma.A comparison of the effects of acute and chronic angle closure.Arch Ophthalmol.1975;93(6):409-11.
8.王宁利,欧阳洁,周文炳等.中国人闭角型青光眼房角关闭发病机制的研究.中华眼科杂志.2000;36(1):46-51
9.Curran EJ:New operation for glaucoma involving a new principle in the etiology and treatment of chronic primary glaucoma.Arch Ophthalmology,1920,49:131.
10.Gazzard G,Friedman DS,Devereux JG,et al.A prospective ultrasound biomicroscopy evaluation of changes in anterior segment morphology after laser iridotomy in Asian eyes.Ophthalmology 2003;110:630-8.
11.Jin JC,Anderson DR.The effect of iridotomy on iris contour.Am J Ophthalmol 1990;110:260-3.
12.Salmon JF.Long-term intraocular pressure control after Nd-YAG laser iridotomy in chronic angle-closure glaucoma.J Glaucoma 1993;2:291-6.
13.Alsagoff Z,Aung T,Ang LP,Chew PT.Long-term clinical course of primary angle-closure glaucoma in an Asian population.Ophthalmology 2000;107:2300-4.
14.Garudadri CS,Chelerkar V,Nutheti R.An Ultrasound Biomicroscopic Study of the Anterior Segment in Indian Eyes with Primary Angle-Closure Glaucoma.J Glaucoma. 2002;11(6):502-7.
15. He M, Friedman DS, Ge J, et al. Laser peripheral iridotomy in eyes with narrow drainage angles: ultrasound biomicroscopy outcomes. The Liwan Eye Study. Ophthalmology. 2007; 114(8): 1513-9.
16. Aung T, Ang LP, Chan SP, Chew PT. Acute primary angle-closure: long-term intraocular pressure outcome in Asian eyes. Am J Ophthalmol. 2001;131(1):7-12.
17. Choi JS, Kim YY. Progression of peripheral anterior synechiae after laser iridotomy. Am J Ophthalmol. 2005; 140(6): 1125-7.
18. Pavlin CJ, Foster FS. Ultrasound biomicroscopy in glaucoma. Acta Ophthalmol Suppl 1992;204:7-9.
19. Tornquist R. Angle closure glaucoma in a patient with a plateau type of iris. Acta Ophthalmol (Copenh)1958;36:419-423.
20. Wand M, Grant WM, Simmons RJ, et al. Plateau iris syndrome. Trans Am Acad Ophthalmol Otolryngol 1977;83:122-129.
21. Ritch R. Plateau iris is caused by abnormally positioned ciliary processes. J Glaucoma 1992; 1:23-26.
22. Pavlin CJ, Ritch R, Foster FS. Ultrasound biomicroscopy in plateau iris syndrome. Am J Ophthalmol 1992;113:390-5.
23. Pavlin CJ, Foster FS. Plateau iris syndrome: changes in angle opening associated with dark, light and pilocarpine administration. Am J Ophthalmol 1992;128:288-91.
24. Kumar RS, Baskaran M, Chew PT, Friedman DS, Handa S, Lavanya R, Sakata LM, Wong HT, Aung T. Prevalence of plateau iris in primary angle closure suspects an ultrasound biomicroscopy study. Ophthalmology. 2008 ;115(3):430-4.
25. Lowe RF. Primary angle-closure glaucoma. Prevention and early treatment. Isr J Med Sci 1972;8:1362-5.
26. Fleck BW, Wright E, McGlynn C. Argon laser pretreatment 4 to 6 weeks before Nd:YAG laser iridotomy. Ophthalmic Surg 1991;22:644-9.
27. Ang LP, Aung T, Chew PT. Acute primary angle closure in an Asian population: long-term outcome of the fellow eye after prophylactic laser peripheral iridotomy. Ophthalmology 2000;107:2092-6.
28.Wilensky JT,Kaufman PL,Frohlichstein D,et al.Follow-up of angle-closure glaucoma suspects.Am J Ophthalmol 1993;115:338-46.
29.叶天才,于强,彭寿雄等.原发性闭角型青光眼易患者六年随访研究.中华眼科杂志.1998;34(3):167-9.
30.Thomas R,George R,Parikh R,Muliyil J,Jacob A.Five year risk of progression of primary angle closure suspects to primary angle closure:a population based study.Br J Ophthalmol.2003;87(4):450-4.
31.Friedman DS.Who needs an iridotomy? Br J Ophthalmol.2001;85(9):1019-21.
32.Lim LS,Husain R,Gazzard G,Seah SK,Aung T.Cataract progression after prophylactic laser peripheral iridotomy:potential implications for the prevention of glaucoma blindness.Ophthalmology.2005;112(8):1355-9.
33.Corneal endothelial damage after neodymium:YAG laser iridotomy.Wu SC,Jeng S,Huang SC,Lin SM.Ophthalmic Surg Lasers.2000;31(5):411-6.
34.Foster PJ,Baasanhu J,Alsbirk PH,Munkhbayar D,Uranchimeg D,Johnson GJ.Glaucoma in Mongolia.A population-based survey in H6vsg61 province,northern Mongolia.Arch Ophthalmol.1996;114(10):1235-41.
2.Gazzard G,Friedman DS,Devereux JG,et al.A prospective ultrasound biomicroscopy evaluation of changes in anterior segment morphology after laser iridotomy in Asian eyes.Ophthalmology.2003;110(3):630-8.
3.Jin JC,Anderson DR.The effect of iridotomy on iris contour.Am J Ophthalmol 1990;110:260-3.
4.He M,Friedman DS,Ge J,et al.Laser peripheral iridotomy in eyes with narrow drainage angles:ultrasound biomicroscopy outcomes.The Liwan Eye Study.Ophthalmology.2007;114(8):1513-9.
5.Choi JS,Kim YY.Progression of peripheral anterior synechiae after laser iridotomy.Am J Ophthalmol.2005;140(6):1125-7.
6.Aung T,Ang LP,Chan SP,et al.Acute primary angle-closure:long-term intraocular pressure outcome in Asian eyes.Am J Ophthalmol.2001;131(1):7-12.
7.Garudadri CS,Chelerkar V,Nutheti R.An Ultrasound Biomicroscopic Study of the Anterior Segment in Indian Eyes with Primary Angle-Closure Glaucoma.J Glaucoma.2002;11(6):502-7.
8.Tello C,Liebmann J,Potash SD,et al.Measurement of ultrasound biomicroscopic images:intraobserver and interobserver reliability.Invest Ophthalmol Vis Sci 1994;35:3549-52.
9.Spaeth GL,Azuara-Blanco A,Araujo SV,et al.Intraobserver and interobserver agreement in evaluating the anterior chamber angle configuration by ultrasound biomicroscopy.J Glaucoma 1997;6:13-7.
10.赵家良,睢瑞芳,贾丽君等.北京市顺义县50岁及以上人群中青光眼患病率和正常眼眼压的调查.中华眼科杂志,2002;38:355-9.
11.王宁利,欧阳洁,周文炳等.中国人闭角型青光眼房角关闭发病机制的研究.中华眼科杂志.2000;36(1):46-51.
12. He M, Foster PJ, Johnson GJ, et al.. Angle-closure glaucoma in East Asian and European people. Different diseases? Eye. 2006; 20(1):3-12.
13. American Academy of Ophthalmology. Laser peripheral iridotomy for pupillary-block glaucoma. Ophthalmology 1994; 101:1749-58.
14. Nolan WP, Foster PJ, Devereux JG, et al. YAG laser iridotomy treatment for primary angle closure in east Asian eyes. Br J Ophthalmol 2000;84:1255-9.
15. Ritch R. Plateau iris is caused by abnormally positioned ciliary processes. J Glaucoma 1992; 1:23-26.
16. Pavlin CJ, Ritch R, Foster FS. Ultrasound biomicroscopy in plateau iris syndrome. Am J Ophthalmol 1992;113:390-5.
17. Pavlin CJ, Foster FS. Plateau iris syndrome: changes in angle opening associated with dark, light and pilocarpine administration. Am J Ophthalmol 1992; 128:288—91.
1.美国眼科学会(赵家良等译).眼科临床指南.北京:人民卫生出版社.2006:122-143.
2.赵家良,睢瑞芳,贾丽君等.北京市顺义县50岁及以上人群中青光眼患病率和正常眼眼压的调查.中华眼科杂志,2002;38:355-9.
3.葛坚,赵家良,崔浩.眼科学.北京:人民卫生出版社.2005:249-54.
4.Foster PJ,Buhrmann R,Quigley HA,Johnson GJ.The definition and classification of glaucoma in prevalence survey.Br J Ophthalmol.2002;86(2):238-42.
5.He M,Foster PJ,Johnson GJ,Khaw PT.Angle-closure glaucoma in East Asian and European people.Different diseases.Eye.2006;20(1):3-12.
6.Dhillon B,Chew PT,Lim ASM.Field loss in primary angle-closure glaucoma.Asia-Pac J ophthalmology 1990;2:85-87.
7.Douglas GR,Drance SM,Schulzer M.The visual field and nerve head in angle-closure glaucoma.A comparison of the effects of acute and chronic angle closure.Arch Ophthalmol.1975;93(6):409-11.
8.王宁利,欧阳洁,周文炳等.中国人闭角型青光眼房角关闭发病机制的研究.中华眼科杂志.2000;36(1):46-51
9.Curran EJ:New operation for glaucoma involving a new principle in the etiology and treatment of chronic primary glaucoma.Arch Ophthalmology,1920,49:131.
10.Gazzard G,Friedman DS,Devereux JG,et al.A prospective ultrasound biomicroscopy evaluation of changes in anterior segment morphology after laser iridotomy in Asian eyes.Ophthalmology 2003;110:630-8.
11.Jin JC,Anderson DR.The effect of iridotomy on iris contour.Am J Ophthalmol 1990;110:260-3.
12.Salmon JF.Long-term intraocular pressure control after Nd-YAG laser iridotomy in chronic angle-closure glaucoma.J Glaucoma 1993;2:291-6.
13.Alsagoff Z,Aung T,Ang LP,Chew PT.Long-term clinical course of primary angle-closure glaucoma in an Asian population.Ophthalmology 2000;107:2300-4.
14.Garudadri CS,Chelerkar V,Nutheti R.An Ultrasound Biomicroscopic Study of the Anterior Segment in Indian Eyes with Primary Angle-Closure Glaucoma.J Glaucoma. 2002;11(6):502-7.
15. He M, Friedman DS, Ge J, et al. Laser peripheral iridotomy in eyes with narrow drainage angles: ultrasound biomicroscopy outcomes. The Liwan Eye Study. Ophthalmology. 2007; 114(8): 1513-9.
16. Aung T, Ang LP, Chan SP, Chew PT. Acute primary angle-closure: long-term intraocular pressure outcome in Asian eyes. Am J Ophthalmol. 2001;131(1):7-12.
17. Choi JS, Kim YY. Progression of peripheral anterior synechiae after laser iridotomy. Am J Ophthalmol. 2005; 140(6): 1125-7.
18. Pavlin CJ, Foster FS. Ultrasound biomicroscopy in glaucoma. Acta Ophthalmol Suppl 1992;204:7-9.
19. Tornquist R. Angle closure glaucoma in a patient with a plateau type of iris. Acta Ophthalmol (Copenh)1958;36:419-423.
20. Wand M, Grant WM, Simmons RJ, et al. Plateau iris syndrome. Trans Am Acad Ophthalmol Otolryngol 1977;83:122-129.
21. Ritch R. Plateau iris is caused by abnormally positioned ciliary processes. J Glaucoma 1992; 1:23-26.
22. Pavlin CJ, Ritch R, Foster FS. Ultrasound biomicroscopy in plateau iris syndrome. Am J Ophthalmol 1992;113:390-5.
23. Pavlin CJ, Foster FS. Plateau iris syndrome: changes in angle opening associated with dark, light and pilocarpine administration. Am J Ophthalmol 1992;128:288-91.
24. Kumar RS, Baskaran M, Chew PT, Friedman DS, Handa S, Lavanya R, Sakata LM, Wong HT, Aung T. Prevalence of plateau iris in primary angle closure suspects an ultrasound biomicroscopy study. Ophthalmology. 2008 ;115(3):430-4.
25. Lowe RF. Primary angle-closure glaucoma. Prevention and early treatment. Isr J Med Sci 1972;8:1362-5.
26. Fleck BW, Wright E, McGlynn C. Argon laser pretreatment 4 to 6 weeks before Nd:YAG laser iridotomy. Ophthalmic Surg 1991;22:644-9.
27. Ang LP, Aung T, Chew PT. Acute primary angle closure in an Asian population: long-term outcome of the fellow eye after prophylactic laser peripheral iridotomy. Ophthalmology 2000;107:2092-6.
28.Wilensky JT,Kaufman PL,Frohlichstein D,et al.Follow-up of angle-closure glaucoma suspects.Am J Ophthalmol 1993;115:338-46.
29.叶天才,于强,彭寿雄等.原发性闭角型青光眼易患者六年随访研究.中华眼科杂志.1998;34(3):167-9.
30.Thomas R,George R,Parikh R,Muliyil J,Jacob A.Five year risk of progression of primary angle closure suspects to primary angle closure:a population based study.Br J Ophthalmol.2003;87(4):450-4.
31.Friedman DS.Who needs an iridotomy? Br J Ophthalmol.2001;85(9):1019-21.
32.Lim LS,Husain R,Gazzard G,Seah SK,Aung T.Cataract progression after prophylactic laser peripheral iridotomy:potential implications for the prevention of glaucoma blindness.Ophthalmology.2005;112(8):1355-9.
33.Corneal endothelial damage after neodymium:YAG laser iridotomy.Wu SC,Jeng S,Huang SC,Lin SM.Ophthalmic Surg Lasers.2000;31(5):411-6.
34.Foster PJ,Baasanhu J,Alsbirk PH,Munkhbayar D,Uranchimeg D,Johnson GJ.Glaucoma in Mongolia.A population-based survey in H6vsg61 province,northern Mongolia.Arch Ophthalmol.1996;114(10):1235-41.