巩膜睫状体光凝术对难治性青光眼的中长期疗效  

Mid-long term efficacy of transscleral cyclophotocoagulation in the treatment of refractory glaucoma

作　　者：金陈进[1] 葛坚[1] 钟晓菁[1] 周少博[1] 陈慧怡[1] 江儒章[1] 

机构地区：[1]中山大学中山眼科中心,广州510060

出　　处：《中国实用眼科杂志》2004年第12期983-985,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的　评价经巩膜 810nm半导体激光睫状体光凝术对难治性青光眼的中长期疗效。方法　回顾性地分析了 65例 (65只眼 )经巩膜睫状体光凝的难治性晚期青光眼 ,时间从 1998年 10月至 2 0 0 0年 10月 ,随访 2 4m～ 46m (平均 3 4 1m± 5 8m ) ,观察指标包括包括眼压、视力、用药数量、眼痛情况和眼球萎缩发生率。结果　术前平均眼压 5 1 2mmHg± 14 3mmHg ;最后一次随访 ,平均眼压 16 1mmHg± 11 2mmHg ;最后眼压在 6mmHg～ 2 1mmHg之间者有 41眼 (63 1% ) ,经配对资料T检验 ,术前眼压与术后眼压相比 ,差异有显著性 ,P <0 0 1。术后 46只眼 (70 8% )视力保持不变 ;18只眼 (2 7 7% )视力下降 ;1只眼 (1 5 % )视力增加。抗青光眼用药种类从治疗前的平均3 1种降至治疗后平均 0 4种 (P <0 0 1)。术前有眼痛的患者中 93 3 %的眼痛症状显著缓解或消失。7只眼 (10 8% )发生眼球萎缩。结论　经中长期随访观察 ,810nm半导体激光经巩膜睫状体光凝术仍是治疗难治性青光眼的有效方法。Objective To evaluate the mid-long-term efficacy of 810nm-semiconductor laser transscleral cyclophotocoagulation(TSCPC)for advanced refractory glaucoma.Methods Retrospective analysis was made of 65 patients(65 eyes)with advanced intractable glaucoma treated with diode laser cyclophotocoagulation between October 1998 and October 2000.Clinical data including intraocular pressure(IOP),visual acuity,number of medications,eye-pain and occurrence of atrophy of eyeball were reviewed.Mean follow-up was 34 1±5 8months(range 24～46months).Results Mean preoperative IOP was 51 2±14 3mmHg.At final follow-up examination,mean final IOP was 16 1±11 2mmHg,forty-one(63 1%)eyes had the final IOP between 6mmHg and 21mmHg.Using a paired t test,the difference between preoperative IOP and postoperative IOP was statistically significant( P <0 01).Vision kept no change in 46 eyes(70 8%);vision decreased in 18 eyes(27 7%);elevated vision recorded in 1 eye(1 5%),Mean preoperative number of medications was 3 1,mean final number of medications was 0 4.The difference between pre-and postoperative number of medications was statistically significant( P <0 01).93 3% of pain eyes was remarkably relieved.Atrophy of eyeball occurred in seven eyes(10 8%).Conclusions 810nm-semiconductor laser transscleral cyclophotocoagulation still provided a useful efficacy for the treatment of eye with refractory advanced glaucoma through mid-long-term observation.

关 键 词：巩膜 眼压 睫状体光凝术 难治性青光眼 中长期疗效 术前 视力 结论 有效方法 显著性 

分 类 号：R775[医药卫生—眼科] R779[医药卫生—临床医学]