Nguyen Huu Qudc Nguyen Tap chi KHOA HOC & CONG NGHE 81(05): 153- 159
KET QUA DIEU TRI GLOCOM GOC DONG NGUYEN PHAT BANG C A T MONG MAT CHU BIEN LASER ND: YAG
TAI KHOA MAT BENH VIEN C DA NANG
Nguyen Huu Quoc Nguyen Khoa Y Dugc - DH Dd Ndng
TOMTAT
Muc tieu: Nhan xet dac diem lam sang GIdcdm gdc ddng nguyen phat, va ket qua dieu trj sau cat mdng mat chu bien bang Laser Nd: Yag. Doi tugng va phuong phap nghien cuu: md ta tien cdu 46 mat dugc cat mdng mat chu bien bang Laser Nd: Yag, danh gia ket qua nhan ap, do md gdc tien phdng tai thdi diem 2 tuan, I thang, 3 thang. Ket qua nghien cuu: Benh nhan tren 60 tudi (80%), benh nhan nu chiem 73,33%. Benh vao vien cd trieu chung nhin md (43,48%), nhdc mat 19,65%, trieu chung thuc the chd yeu la lien phdng ndng va ddng tu gian hoac phan xa ludi. Hinh thai GIdcdm man tinh va so phat chiem 69,57%. Ket qua nhan ap sau 2 tuan X = 18,17 ± 1,37 mmHg, giam 7,66 mmHg so vdi trudc laser. Dp md gdc tien phdng tang ro ret sau 2 luan dieu trj.
sau 1 thang va 3 thang, khdng cd sir bien ddi nao dang ke. Cd mdi tuong quan nghjch bien giua do md rpng gdc tien phdng trudc dieu trj vdi mdc ha nhan dp sau dieu trj va cd cd sir tuong quan thuan chieu giua mdc ha nhan dp va muc tang dp md rdng gdc lien phdng sau dieu trj. Ket luan:
Laser Nd: Yag cd hieu qua ha nhan ap va md rpng gdc tien phdng d benh nhan GIdcdm gdc ddng nguyen phat.
Til- khoa: gidcdm gdc ddng nguyen phdt, cdt mdng mat chu blin laser nd; yag BAT VAN DE
GIdcdm Id mdt trong benh mdt phd bien trong nhan khoa vd cung Id nguyen nhdn gdy md dung thu hai tren the gidi sau benh due thdy linh the, theo bao cdo cua Td chue Y te The gidi se cd khoang 60,5 trieu ngudi bj GIdcdm gdc md vd gdc ddng vdo ndm 2010. O Viet Nam, GIdcdm gay mu dung hdng thu ba sau benh due thdy tinh the va benh phdn sau nhan cdu.
Trudc ddy, de dieu trj GIdcdm gdc ddng ngudi ta dp dung phdu thudl cdt mdng mdt chu bien (CMMCB), cdt mgl mdnh nhd mdng mat d chu bien qua dudng rach vung ria lao mgl Id nhd de thuy dich cd the luu thdng de dang tu hdu phdng ra lien phdng, giai phdng hien lugng nghen ddng tir, ddng thai gdc tien phdng md rdng kip thdi Idm ha nhdn dp (NA).
Tuy nhien ddy cung Id mdt phdu thuat ndi nhan nen cd the gap nhieu bien chung.
Vdi su phat trien cda khoa hgc ky thuat. Laser Nd: YAG ra ddi vdi nhieu linh ndng vugt trdi ngay cdng dugc ua chudng de CMMCB. Nam 1990, Laser Nd: YAG lan dau tien dugc ung dung lai Viet Nam, den nay Laser Nd: YAG
Tel: 09(13557357. Email: nguyeiidean60>d]gmail.com
da dugc dua vdo dng dung rdng rdi tai cdc trung tdm nhdn khoa Idn vdi ket qud rdt tdt.
Ky thuat nay dugc ung dung tai Benh vien C nam 2009, vd vdn cdn it bdo cdo trong nude ve vdn de ndy. Do vay chdng ldi thuc hien nghien cuu de tdi "Kit qud diiu tri GIdcdm gdc dong nguyin phdt bdng cdt mdng mdt chu biin LASER Nil: YAG tiii Khoa Mdt Binh viin CDd Ndng" nham muc tieu:
1. Nhdn xet dgc diem ldm sdng GIdcdm gdc ddng nguyen phdt.
2. Ddnh gid kit qud Laser Nd: Yag (Nhdn dp, do md gdc)
TONG QUAN
Ca chi cdt mong mdt hdng Laser Nd: YAG dieu tri GIdcdm goc ddng nguyin phdt : la tia laser di qua giac mac tao Id md tren mdng mat md khdng phdi md nhdn cdu, lao dudng luu thdng mdi cho thuy dich lu hdu phdng ra tiln phdng gidi quyet dugc ca che nghen ddng tu. Khi thuy dich luu thdng dugc ra lien phdng thi dp luc hdu phdng gidm xudng, chdn mdng mdt khdng bi ddy ra trudc, nhd dd tien phdng md rdng ddng ke, giup thiiy dich luu thdng ra ngoai nhan cdu.
f,im:i'ii^mm,ii-'3-^wii0'm»iik-w
Hinh 1. Co che dieu ha DOI TUONG VA PHU'ONG PHAP NGHIEN CUU : . Doi tugng nghien ciru
Ddi tugng nghien cuu gdm 46 mat (30 benh nhdn) dugc khdm, CMMCB bang laser Nd:
YAG lai khoa Mdt Benh vien C Dd Ndng tu 09/2009-09/2010.
Tieu chudn chgn benh: Benh nhan GIdcdm gdc ddng nguyen phdt giai doan so- phdt, ban cap, cap tinb vd man linh, khi soi gdc tien phdng ddng < 180°.
Tieu chudn logi trir: Id nhung mat tien phdng ndng qua ndng, nhung mdt cd benh ly giac mac mdng maL viem nhiem hoac mat cd lien su chdn thuong.
Phuong phdp nghien ciru:
Phuong phdp md td, tien cuu tdt cd ede trudng hgp GIdcdm gdc ddng nguyen phat duge dieu trj CMMCB bdng Laser Nd: Yag.
- Tien hdnh khdm benh, ddnh gid do md gdc lien phdng trung binh (MGTPTB) theo phdn loai cua Shacheff de dua ra chi djnh CMMCB cho benh nhdn bdng may Laser Nd: YAG Opto advant.
- Ky thudl laser: Dat kinh tiep xdc vdo mdt benh nhdn, ddt muc ndng lugng can thiet tuy tinh trang mdng mat tu 4-6 mj. Chgn vj tri ban laser tren mdng mdt (ihudng tir 10h30 den lh30), tim nhung vj tri mdng, hd tren mdng mat de bdn. Sd Idn bdn ed the Ien den 10 phdt, tdng nang lugng nen nhd hon 60mj,
nhan dp cda Laser Nd: YAG
- Danh gid ket qua thi lire, nhan dp, do MGTPTB (theo phan loai Schaffer), Idm gai, thj trudng tai eae thdi diem sau laser 2 tuan, 1 thang, 3 thdng.
- Sd lieu duge xu Ii theo chuang trinh thdng ke y hge Epi-info
KET QUA vA BAN LUAN Dac diem lam sang
* Phdn bd benh nhdn theo tudi vd gidi:
Benh tren 60 tuoi ehiem ty le 80%, vdi tudi trung binh Id -^ = 66,96 ± 7,8, Theo nghien euu eua Tin Aung tudi trung binh cda benh nhdn Id 62,0 ± 9,0.
Benh nhan nir chiem 13,33% cao gap gan 3 lan so vdi nam, ket qud ndy Id hgp ly vi phu hgp vdi nghien cuu djch te hge thi nu gidi gap nhieu gap 3 Ian nam gidi. Theo Nguyen Cudng Nam niJ gidi chiem 71,9%, nghien cdu eua Tin Aung nu' gidi chiem 67,8%. So sanh vdi ede tae gid tren eho thay su khde biet khdng cd y nghTa thdng ke (p > 0,05).
* Trieu chimg ca ndng:
Benh nhdn chu yeu gap trieu ehurng nhin md ehiem 43,48%), ke den Id nhuc mat chiem 19,65%), nhin ed quang xanh dd chiem 8,69%, trieu ehung budn ndn va ndn ehiem ty le 6,67%,. Cdc ty le ndy phij hgp vdi cdc hinh thdi gidcdm d muc 1.4.
* Trieu chimg thuc the:
Tat ca benh nhan deu cd tien phdng ndng, ddng tu gian hoac phdn xa ludi chiem 54,35%, cuong tu ria chiem 34,78%, phu giac mac chiem 30,43%), phii hgp vdi 14 mdt bj
Nguyen Hiru Qudc Nguyen Tap chi KHOA HOC & CONG NGHE 81(05): 153- 159
* Giai dogn GIdcdm:
Benh chu yeu gap d giai doan man tinh vd so phat chiem ty le 69,57%. GIdcdm cdp tinh gap it nhat (8,69%). Nghien cuu cua Tomey K. F vd cdng su thi ty le chu yeu la GIdcdm gdc ddng man tinh chiem 60,5%.
Tuy nhien lbeo nghien cuu cua chdng tdi (Nguyen Nam Trung 2006) GIdcdm cap chiem 65,8%) (48/73 mdt). So sanh vdi nghien cdu nay su khac biet ed y nghTa thdng ke (p
<0.01). Sir khde biet do tieu chuan chgn benh tai Hue chd yeu benh GIdcdm cd chi djnh phdu thuat cat be.
* Thi lire benh nhdn trudc vd sau dieu tri:
Benh nhan vdo vien ehu yeu cd thj luc tu 3/10 - 7/10 chilm 56,52%, Thj luc dudi 1/10 chiem_13,04%). Thj luc trung binh luc vdo vien ^ = 0,47 ± 0,26.
Thj lire trung binh sau 2 tuan la 0,51 ± 0,25, sau 1 thang la 0,53 ± 0,24, sau 3 thdng 0,52 ± 0,25. Nhu vdy thj luc sau dieu trj tdng so vdi ldc vao vien, tang chu yeu d GIdcdm cap vd ban cap. Tuy nhien su khde biet (p>0,05).
* Nhdn dp benh nhdn luc nhdp vien:
Nhan dp trung binh luc nhdp vien Id 25,83 mmHg, Nhan dp cao nhdt Id 45 mmHg, thap nhdl Id 18 mmHg. Tang cao nhdt Id nhdm GIdcdm cdp tinh, su khde biet cd y nghTa thong ke(p<0,01).
Tran Thj Nguyet Thanh (2008), nhan dp ldc nhap vien Id 19,87 ± 3,99 mmHg. Ty le cua chdng tdi cao hon vi ldc gia chi nghien cuu GIdcdm giai doan tiem tdng vd so phdt. Theo Hodng Nggc Chuong (1995) nhdn dp trung
Bang 1. Gdc tien phdng
binh cda benh nhdn khi nhap vien tai khoa mat benh vien Trung uong Hul Id 44.96 mmHg, ty le nay cao hon vi lieu chuan chgn benh cua tdc gid cung khde chdng tdi.
* Tinh trgng ldm dia trudc vd sau dieu tri:
Trudc dilu trj ty le Idm dTa 0.3<C/D<0.6 chilm ty le cao nhdt (67,39%), Idm dTa > 0.6 chiem 17,39%, gai thj binh thudng chilm
15,22%. Sau khi dieu trj 3 thdng ldm gai <0,3 tang len 2 mat, vd ldm gai 0.3<C/D<0.6 it hon 2 mat. Nhu vdy tinh trang gai thj gdn nhu khdng thay ddi so vdi trudc dieu trj.
* Tinh trgng thi trudng trirdc vd sau dieu tri Laser:
Chung tdi chi do thj Irudng dugc 30 mdt.
Trudc dieu trj cd 7 mat (23,33%) chua ton thuong thj trudng tuong ung vdi 7 mat chua ldm dTa. Tdn thuong thj trudng trung binh chiem ty le cao nhdt (36,67%)), ke din Id ton thuong thj trudng nhe 26,67%). Sau 3 thdng khdng cd mat nao thj trudng xdu di, hdu het benh nhdn cd thj Irudng dn djnh (90%), cd 3 mat thj trudng tdt len (10%) cd 3 mdt ndy deu gap d GIdcdm ban cdp.
* Tinh trgng gdc tiin phdng trudc dieu tri:
Dd MGTPTB thap nhdl d nhdm GIdcdm cap tinh 0,81 ± 0,32, vd cao nhat d nhdm GIdcdm so phat 2,38 ± 0,53. Do MGTPTB chung Id
1,76 ±0,65.
Nghien cuu cua chdng ldi cung gan luong ddng vdi nghien cuu eda Pham Tan Tien (2008) cd do md gdc trung binh Id 1,71 ± 0,40, va Hd Thj Tuyet Nhung cd do md gdc trung binh 1,71 ±0,53.
trung binh trudc dieu tri.
Giai doan So pbal Ban cap Cap tinh Man tinh Tong so
So mat 15 10 4 17 46
Do MGTPTB 2,38
1,15 0,81 1,81 1,76
Do lech chuan 0,53 0,24 0,12 0,32 0,65
Thap nhat 1,75 0,75 0,75 1,25 0,75
Cao nhat 3,75
1,5 LO 2.25 3.75 E
Ket qua dieu trj
* Do md gdc tiin phdng trung binh
Bang 2. Dp md rdng gdc tien phdng sau dieu trj
Sau 2 tuan
Sau 1 thang
Sau 3 thang
So pbal Ban cap Cap tinh Man tinh Tdng sd So phat Ban cap Cap tinh Man tinh Tdng sd So phat Ban cap Cap tinh Man tinh Tdng sd
Sd mat
15 10 4 17 46 15 10 4 17 46 15 10 4 17 46
Dp md gdc TP 3,07 2,75 2,94 2,54 2,79 3,23 2,87 2,75 2,62 2.89 3,35 2,97 2,88 2,66 2,97
Dp lech chuan
0,44 0,44 0,51 0,36 0,46 0,39 0,49 0,58 0,42 0.51 0,42 0,45 0,47 0,41 0,51
Thap nhdt 2,25 2,25 2,50 1,75 1,75 2,5 2,25 2,25 2,00 2,0 2,75 2,25 2,25 2,00 2.00
Cao nhat 4,00 3,50 3,50 3,25 4,00 3,75 3,75 3,25 3,5 3.75 4,00 3,75 3,25 3,50 4,00
Pl
p < 0 , O I
p < 0 , O I
p < 0 , 0 1
p2
p > 0,05
Tai thdi diem 2 tudn sau dieu trj, cdc mdt nghien cuu deu cd_dd MGTPTB tdng so vdi trudc dieu trj vdi X = 2,79 ± 0,46 (p<0,01).
Trong dd mat GIdcdm gdc ddng cap cd muc tang do md gdc cao nhdt (2,13), ke den la nhdm bdn cdp tdng 1,6. Ket qud cua Tran Thj Nguyet Thanh sau 2 tudn laser do md gdc trung binh Id 2,26 ± 0,37.Do md gdc tai thdi
* Kit qud nhdn dp
diem 1 thdng vd 3 thdng khdng thay ddi may vdi do md gdc luc 2 tudn. Theo nghien cdu cua Laurence S. Lim do md gdc tang dang ke sau 2 tuan laser cat mdng mat vd mdt nam sau van khdng thay ddi, do md gdc trung binh la 1,15, ty le nay thap hon ehung tdi do tdc gid chi lira chgn GIdcdm gde ddng cap tinh cd do md gdc tien phdng trudc laser rat thap 0,74.
Bang3. Ket qua nhan ap sau dilu tri
Sau 2 tuan
thang
Sau 3 thang
So phat Ban cap Cap tinh Man tinh Tdng sd So phat Ban cap Cap tinh Man tinh Tdng sd So phat Ban cap Cap tinh Man tinh Tdng sd
Sd mat 15 10 4 17 46 15 10 4 17 46 15 10 4 17 46
N A T B 18,13
18,1 18,0 18,29 18,17 17,20 17,22 17,75 17,82 17,47 17,46 16,8 17,25 17,82
Do lech chuan
1,35 1,28 1,82 1,45 1.37 1,08 1,03 2,87 1,59 1,46 1,12 0,79 1,26 1,42
Thap nhat
16 16 16 16 16 16 16 16 16 16 16 16 16 16
Cao nhat 21 20 20 22 22 19 19 22 23 23 19 18 19 22
P l
p > 0,05
p > 0,05
p > 0,05
P 2
p > 0,05
Nguyen Hiru Qudc Nguyen Tap chi KHOA HOC & CONG NGHE 81(05): 153- 159 Sau 2 tudn dieu Irj nhdn dp trung binh ^ =
18.17 ± 1,37 mmHg, gidm 7,66 mmHg so vdi trudc dieu Iri (p<0,01). Trong dd nhdm GIdcdm cdp linh ha nhan dp nhilu nhat 23,35 mmHg, ke den la GIdcdm bdn cap muc ha nhan dp Id 11,2 mmHg, thdp nhdt Id nhdm GIdcdm so phdt chi ha dugc 3,2 mmHg.
Sau 1 thdng vd 3 thdng nhan dp trung binh cd ha them, tuy nhien su khde biet khdng cd y nghTa thdng ke vdi p > 0,05.
Nghien cuu cda Nguyen Phat Trudc Tien nhan dp trung binh sau 3 thdng Id 16,00 mmHg, vd cua Pham Tan Tien Id 17,35 mmHg.
Cac moi lien quan
* Mdi lien quan giira do MGTPTB trudc laser vd mirc hg NA sau laser:
Trong nghien cdu chdng tdi nhdn thdy khi gdc tien phdng trudc dieu trj cdng nhd thi muc ha nhan dp cdng nhieu. Chinh vi vdy chung ldi tim mdi lien quan giua do MGTPTB trudc
dieu trj vdi muc ha NA sau dilu trj. Vd thdy rang chdng cd mdi tuong quan nghjch bien vdi he sd tuong quan r = - 0,768 (n = 46, p < 0,01).
phuong trinh hoi quy luyln tinh y = - 7,214 + 20,396, trong dd y la muc ha nhdn dp sau dieu trj 2 tudn, x Id gdc tien phdng trudc dieu tri.
* Mdi lien quan giira mirc tdng do MGTPTB vd mirc hg NA sau dieu tri
Chung la cung nhdn thdy khi mdc lang do md rdng gdc tien phdng cdng nhieu thi nhdn dp sau dieu trj ha cdng nhieu. Tim mdi lien quan giua hai bien sd lien luc ndy chdng ta nhdn thdy, chung cd su tuong quan chat che, thudn chieu giu'a muc ha nhan dp vd mdc tdng do md rdng gdc lien phdng sau dieu Irj, vdi r
= 0,866, dugc the hien bang phuong trinh hdi quy tuyen tinh bac 1 y = 8,476x - 1,054, trong dd y Id muc ha nhan dp sau dieu trj, x Id muc tang dd md rdng gdc lien phdng.
Ol
X E E a.
•a c 30 n 25<
20 15 10 5 - 0 - vao
25,83
vien
• * * * " * . ^ ^ 18,17
• ~ ~
sau 2 tuan
17,47
sau 1 thang
17,43
sau 3 thang
Bleu do 1. Nhan dp trung binh trudc dieu tri va sau dieu trj Bang 4. Mdi lien quan giua gdc tien phdng trudc phdu thuat va muc ha NA Dp md gdc TP
trung binh 1,76 ±0,65
Bang 5
Nhan ap mmHg Dp md goc tien phdn
Bang Muc tang dd md gdc 1,03 ±0,63
Mdc ha nhan ap trung binh sau 7,65 ±6,15
2 tuan He sd tuong quan -0,768
Dudng hd y = -7,214 + . Thay ddi nhan dp va dp md rpng gdc tien phdng trudc va sau dieu trj
Trudc dieu tri 25,83 ± 6 . 0 g 1,76 ±0,65
Sau dieu tri I 8 , I 7 ± 1,37 2,79 ± 0,46
6. Su lien quan giira dp md rdng gdc TP va mdc ha NA sau TPTB Muc ha NA trung binh
7,65 ±6,15
sau 2 tuan He sotuonuquan 0,866
Muc thay ddi 7,65 ±6,15
1,03 ±0.63 dieu tri
Dudng hdi y = 8,476x
quy 20,396
quy - 1,054
Bieu do 2.Tuong quan giua muc tang md gdc lien phdng va mdc ha nhan dp sau dieu tri Lurence S va cdng su cho rdng cd mdi lien
quan giua do md rdng gdc tien phdng vd muc ha nhdn dp sau laser cat mdng mat chu bien dieu trj gidcdm gdc ddng cap. Tdc gid cho rdng CMMCB Idm ba nhan dp trung binh 3mmHg.
KET L U A N
Qua nghien cuu 46 mat GIdcdm gdc ddng nguyen phat dugc dieu trj CMMCB bdng laser Nd: Yag lai Khoa Mdt benh vien C Dd Ndng lu thdng 09/2009 - 10/2010, chung tdi rut ra mdt sd ket ludn nhu sau:
Dac diem lam sang
- Djch te: Benh nhdn tren 6Q_tudi chiem ty le 80%o, vdi ludi trung binh Id ^ = 66,96 ± 7,8, benh nhan nu chilm 73,33%.
- Trieu chung co nang: Benh nhdn chu ylu gdp trieu chdng nhin md chilm 43,48%, kl din Id nhtic mat (19,65%), nhin cd qudng xanh dd chiem 8,69%, trieu ehung budn ndn va ndn chiem ty le 6,67%. Trieu chung thuc the; Tat benh nhan deu ed tiln phdng ndng, ddng tu gian hoac phdn xa ludi chilm 54,35%, cuong tu ria chilm 34,78%o, phu gidc mac chiem 30,43%).
- Hinh thdi GIdcdm; Benh chu ylu gap d giai doan man tinh vd so phdt chiem ty le 69,57%).
GIdcdm cdp tinh gap it nhat (8,69%).
- Thj luc trung binh luc vdo vien ^ = 0,47 ± 0,26. Nhan dp trung binh luc nhdp vien Id 25,83 ± 6 , 0 mmHg
- Ty le ldm dTa 0.3 < C/D < 0.6 chilm ty le 67,39%, tdn thuong thj trtrdng trung binh
Ket qua dieu trj
- Thj lue trung binh sau 2 tuan la 0,51 ± 0,25, sau 1 thang Id 0,53 ± 0,24, sau 3 thang 0,52 ± 0,25.
- Do md gdc trung binh trude dieu trj Id 1,76
± 0,65. Tai thai diem 2 tuan sau dieu trj, cac mat nghien curu deu ed do md gdc trung binh tang so vdi trude dieu trj vdi ^ = 2,79 ± 0,46, vd thdi diem 1 thdng va 3 thdng khdng ed su thay ddi dang ke.
- Sau 2 tuan dieu trj nhan dp trung binh 2( = 18,17±1,37 mmHg, gidm 7,66 mmHg so vdi trude dieu trj, sau 1 thdng va 3 thdng sir thay ddi khdng dang ke.
- Cd mdi tuong quan nghjch bien giua do md rdng gdc tien phdng trude dieu trj vdi muc ha nhan dp sau dieu trj. Cd sir tuong quan thuan chieu giira mue ha nhan dp vd mdc tang do md rdng gdc tien phdng sau dieu trj. Do vay CMMCB bang Laser Nd; Yag ed hieu qua md gdc lien phdng vd ha nhan dp, dae biet hieu qud tren mat ed do MGTPTB thdp (GIdcdm cap vd ban cap). Do md gdc dn djnh sau khi laser 3 thdng, do md rdng gdc tien phdng tang rd ret d nhdm GIdcdm so phdt, nen laser Nd:
cd hieu qua du phdng con GIdcdm cdp d nhdm GIdcdm so phdt vd gdc ddng tiem lang.
TAI LIEU THAM KHAO
[1]. Hoang Nggc Chuong, Trdn Dinh Lap, Ng_uyln Thj Thu (1993), "Nhan xet kit qua 190 phdu thuat cat be cdng giac mac dilu trj Gldcom trong hai nam 1991-1992 tai khoa Mdt Benh vien Trung uong Hue", Tap san nghiin cint vd thdng tin
Nguyin Hiru Qudc Nguyen Tap chi KHOA HOC & CONG NGHE 81(05): 153- 159 dung hg nhdn dp cua phdu thudl tdn nhuyin the
thuy tinh due trin mdt sd trirdng hgp GIdcdm gdc ddng nguyin phdt, luan van Thac sy Y hpc, Dai hpc Y Ha Npi.
[3].Tran Thj Nguyet Thanh (2008), "Danh gia dp md rpng gdc tien phdng sau cat mdng mat chu bien bang Laser Nd: Yag dieu trj GIdcdm gdc ddng nguyen phat", Tgp chi Nhdn khoa, Hdi Nhan khoa Viet Nam 2008, (ll),tr. 69-76.
[4].Nguyen Phat Trudc Tien (2006), Ddnh gid hieu qua diiu trj gdc ddng nguyin phdt bdng Nd; Yag laser Irrldolomy tgl Binh viin Mdt Tp. HCM, luan van Thac sy, Dai hgc Y Dugc Tp Hd Chi Minh.
[5].Pham Tan Tien (2008), Nghiin ciru irng dung
Laser Nd; Yag vdi hai budc song khac nhau cdt mdng mdt chu blin diiu tri GIdcdm goc ddng, luan an Tien sy y hgc, Hpc vien Quan Y.
[6]. Nguyin Nam Trung (2006), Nghiin eini ddc diim ldm sdng vd kit qud diiu tri GIdcdm gdc ddng nguyin phdt tgl Khoa Mdt Benh vien Trung Uong Hue, luan van Bac sy npi tru, trudng Dai hpc Y khoa Hue.
[7]. Laurence S. Lim (2004), "Configuration of the Drainage Angle in the first year after Laser peripheral iridotomy". Ophthalmology, 111 (8), pp 1470-4. '
A B S T R A C T
THE T R E A T M E N T O U T C O M E O F N D : Y A G L A S E R I R I D O T O M Y P R I M A R Y A N G L E - C L O S U R E G L A U C O M A A T C H O S P I T A L O F D A N A N G
IN
Nguyen Huu Quoc Nguyen Faculty of Medicine - Pharmacology, Da Nang University
Objectives: to revie-w the clinical characteristics of primary angle closure glaucoma and the outcome of Nd: YAG laser peripheral iridoctom. Methods: prospective study of 46 eyes underwent iridotomy, evaluation the intraocular pressure and the anterior chamber angle width at 2 weeks, I month, 3 months after treatment. Results: the majority of subjects were female 73,33%, over 60 years old (80%)), blurred vision and decrease visual acuity when the patient hospitalized (43,48%), 19,65%) eye pain, physical symptoms are mainly shallow anterior chamber or pupillary reflexes relaxing lazy. Embryonic glaucoma and chronic angle glaucoma distribution percentage 69.57%. Mean lOP after 2 weeks X = 18,17 ± 1,37 mmHg, 7,66 mmHg lower than before treatment, anterior chamber angle width increased significantly after 2 weeks of treatment. And no significant changer after I month and 3 months. There was a precise inverse relation between anterior chamber angle width before treatment with low levels of lOP after treatment, and there was a precise proportional relation between the low levels of lOP with the increase of chamber angle width after treatment. Conclusion: Nd: YAG laser iridotomy is effective in widening the anterior chamber angle and lowering intraocular pressure in primary angle closure glaucoma.
Keywords: glaucoma, iridotomy in prlinaiy angle-closure, treatment outcome ofNd;YAG laser
Tel: 0903557357. Email; nguyendean60iiTigmall.com
