新生血管性青光眼不同手术疗法的疗效对比
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R779.6

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Contrast of surgical effect of two different operations for neovascular glaucoma
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    摘要:

    目的:对比经巩膜睫状体光凝术和睫状体冷凝术对于新生血管性青光眼的疗效。方法:选取2006年在我院住院的38例43眼新生血管性青光眼患者,一组采用常规睫状体冷凝术18眼,另一组采用810nm激光经巩膜睫状体光凝术治疗25眼,术后处理相同,术后12wk随诊期内观察患者眼部表现、视力、眼压情况。结果:睫状体冷凝组11眼(61%)、睫状体光凝组20眼(80%)术后3mo眼压稳定于11~24mmHg之间,各组术前、后眼压对比,差异均有高度统计学意义(P=0.000);组间术后眼压对比,差异无统计学意义(P=0.669)。睫状体冷凝组10眼(56%)、睫状体光凝组21眼(84%)视力保存,差异有统计学意义(P=0.040)。所有患者术后2wk虹膜新生血管开始逐渐减少,睫状体冷凝患者术后均有明显球结膜充血水肿,并颜面浮肿、眼痛、头痛;睫状体光凝患者术后仅有轻度球结膜混合充血,无颜面部浮肿、头痛及眼痛、前房出血。结论:治疗新生血管性青光眼,睫状体冷凝术及经睫状体激光光凝术控制眼压效果确切;而睫状体激光光凝术手术具有视力保存率高、并发症少,患者术后痛苦少等优点。

    Abstract:

    AIM: To compare the surgical effect between transs-cleral cyclophotocoagulation and cyclocryotherapy for neovascular glaucoma. METHODS: In 2006 from January to December, 38 cases(43 eyes) diagnosed with neovascular glaucoma were treated. 18 cases(18 eyes) were treated with cyclo-cryotherapy and 20 cases(25 eyes) were treated with transscleral cyclophotocoagulation. The post-surgery clinical procedure was no diffrence between two groups. The intraocular pressure(IOP), eyesight, the clinical procedure, and the complications after surgery were observed. RESULTS: During follow-up of 3 months, the IOP of 11 eyes(61%) was controlled from 11 mmHg to 24 mmHg in the cases treated with cyclocryotherapy, and 20 eyes (80%) in the cases treated with cyclophotocoagulation respectively. In each group, there was highly statistical difference between the IOP of pre-operation and post-operation(P=0.000). And there was no statistical diffe-rence between the post-operation IOP of two groups(P=0.669). The visual acuity of 10 eyes (56%) was pre-served in the cases treated with cyclocryotherapy, and 21 eyes(84%) in the cases treated with cyclophotocongula-tion respectively, the result was statistically different(P=0.040). Postoperative complications were found fewer in the cases treated with cyclophotocoagulation, included hypema, pain, anterior chamber haemorrhage, and aqueous flare. CONCLUSION: To controll the IOP of eyes with neovascular glaucoma, transscleral cyclophotocoagula-tion and cyclocryotherapy are both effective and safe. Furthermore, cyclophotocoagulation has fewer postopera-tive complications and pain,it also has higher visual acuity preservation.

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张波.新生血管性青光眼不同手术疗法的疗效对比.国际眼科杂志, 2010,10(4):671-673.

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