目的：通过光学相干断层扫描技术(optical coherence tomography，OCT)观察不同临床类型原发性闭角型青光眼(primary angle-closure glaucoma, PACG)行激光周边虹膜切开术(laser peripheral iris, LPI)前、后前房角开放距离变化，评价治疗效果。方法：选择明确诊断为PACG患者46例50眼，其中 急性闭角型青光眼临床前期及缓解期眼26例27眼，慢性闭角型青光眼20例23眼，行LPI治疗，通过OCT分别检查术前、术后2周距巩膜突500及750 μm处前房角开放距离，采用配对t检验。结果：急性闭角型青光眼LPI术前、术后2周前房角开放距离差异有统计学意义(P<0.05)；慢性闭角型青光眼术 前、术后2周前房角开放距离差异无统计学意义(P>0.05)。结论：急性闭角型青光眼LPI术后前房角开放距离增加，治疗效果较好；慢性闭角型青光眼LPI术后前房角开放距离增加不明显，术后仍存在前房角闭塞趋向。

Objective: To observe the anterior chamber angle opening distance before and after laser peripheral iris (LPI) in patients with different clinical types of primary angle closure glaucoma (PACG) by using optical coherence tomography (OCT), and evaluate the effect of the treatment. Methods: Selected 46 cases (50 eyes) of patients with PACG, including 26 cases (27 eyes) of acute angle closure glaucoma at the preclinical stage and remission phase of ocular and 20 cases (23 eyes) of chronic angle closure glaucoma, implemented LPI, examined the anterior chamber angle opening distance at the point of 500 and 750 μm from posterior to the scleral before and after surgery for 2 weeks by OCT, using a paired t-test. Results: Compared the anterior chamber angle opening distance before and after surgery for 2 weeks, the difference in patients with acute angle closure glaucoma was statistically significant (P<0.05), but not statistically significant in patients with chronic angle closure glaucoma (P>0.05). Conclusion: The opening distance of the anterior chamber angle of the patients with acute angle  closure glaucoma after LPI was increased, and the treatment effect was better; but of the patients with chronic angle closure glaucoma after LPI, the distance was not obviously increased, the tendency of anterior chamber angle occlusion still existed after LPI.

目的：比较翼状胬肉两种不同手术方式后巩膜溶解的发生概率，探讨产生巩膜溶解的原因，选择合理手术方式。方法：对本院两年来263例翼状胬肉采用两种不同的手术方式，观察术后发生巩膜溶解的情况，并通过局部药物进行治疗。结果：263例翼状胬肉患者，130例采用胬肉切除+结膜瓣转位术，裸露角膜缘3 mm巩膜，术后局部滴0.02%丝裂霉素C(mitomycin C, MMC)，胬肉复发26 例，发生巩膜溶解6例；133例采用胬肉切除+角膜缘干细胞移植术，术后滴0.02% MMC，胬肉复发5例，无1例发生巩膜溶解。结论：翼状胬肉术后发生巩膜溶解，是一种严重的手术并发症，可能与术中过度烧灼巩膜面，巩膜板层暴露于MMC有关。采用胬肉切除+角膜缘干细胞移植术，植片覆盖裸露巩膜，促进巩膜表层愈合，术后避免MMC直接浸润巩膜板层故未见此并发症发生。与传统手术方式相比，复发率低，并发症少，是一种安全、有效的翼状胬肉手术方式。

Objective: To compare the occurrence probability of posterior scleral dissolution in two different surgical methods, and to explore the reasons for the dissolution of the scleral. Methods: Using two different surgical methods on 263 cases of pterygium submitted in our hospital in 2 years, observed the occurrence of scleral at postoperative, and treated with topical drugs. Results: Two hundred and sixty three cases of patients with pterygium, 130 cases of pterygium resection and conjunctival flap transposition, bare 3 mm limbus sclera, postoperative topical mitomycin C (MMC). The recurrence of pterygium in 26 cases, scleral melting in 6 cases; 133 cases of pterygium excision and limbal stem cell transplantation, MMC (0.02% MMC drip after operation, 5 cases of recurrent pterygium, no scleral melting occurred in 1 case. Conclusion: The scleral dissolution occurred after pterygium surgery is a serious complication, which may be related to the excessive burning of the scleral surface, and the lamellar exposure to MMC. Excision of pterygium and corneal limbal stem cell transplantation  were used to cover the exposed scleral, promote the surface healing of the wound, and avoid the MMC direct infiltration of the lamina. Compared with the traditional operation mode, the recurrence rate is low, and the complication is little. It is a safe and effective surgical method.