玻璃体手术中联合眼内睫状突光凝治疗晶状体脱位继发青光眼  

Combined laser endoscopic cyclophotocoagulation and vitrectomy in the management of secondary glaucoma due to dislocation of lens

作　　者：何雷[1] 庞秀琴[1] 郑鹏飞[1] 杨勋[1] 史翔宇[1] 

机构地区：[1]首都医科大学附属北京同仁医院眼科中心,100730

出　　处：《眼科》2005年第2期117-120,共4页Ophthalmology in China

摘　　要：目的　观察对外伤性晶状体脱位继发青光眼患者行眼内窥镜下睫状突光凝(endoscopiccyclophotocoagulation ,ECP)联合晶状体玻璃体切除手术的效果。设计　回顾性研究。研究对象　36例(36只眼)晶状体脱位继发青光眼患者。方法　对36例继发性青光眼患者采取晶状体玻璃体切除联合ECP术(采用810nm二极管激光器,能量2 0 0～10 0 0mW ,光凝时间30 0～6 0 0ms ,光凝范围10 0～2 0 0°) ,其中17只眼行人工晶状体缝合固定术。主要指标　眼压,视力,并发症。结果　36例术前平均眼压(34 11±14 0 0 )mmHg。31只眼随诊3～15个月,末次平均眼压(17 2 2±4 17)mmHg。眼压控制率86 11%(31/36 )。另外4只眼眼压失控,再次行抗青光眼手术。36只眼术中无疼痛反应,未发现严重并发症。结论　玻璃体手术联合眼内窥镜下睫状突光凝治疗晶状体脱位继发青光眼,手术直观,操作简单,眼压控制较好,并发症较少。Objective To evaluate the efficacy of laser endoscopic cyclophotocoagulation(ECP)combined with lensectomy and vitrectomy for secondary glaucoma due to traumatic lens dislocation.Design Retrospective case series.Participants 36 patients (36 eyes) with secondary glaucoma due to traumatic lens dislocation.Methods 36 patients were performed with ECP (810nm diobe laser,200～1000mW,300～600ms,range 100～200°) combined with lensectomy and vitrectomy.Suturing IOL was performed in 17 patients.Main Outcome Measures Visual acuity,IOP,and complications.Results The mean preoperative IOP was (34.11±14.00) mmHg.31 patients were followed from 3 to 15 months.At the time of last follow-up,the IOP significantly decreased to (17.22±4.17) mmHg.The total IOP controlling rate was 86.11% (3136).4 cases received secondary antiglaucoma procedures.No severe pain occurred at the time of ECP,and no severe postoperative complications were found in all cases.Conclusion ECP for secondary glaucoma due to dislocation of lens permits operation under direct visualization with few complications.ECP is very simple but considerably efficient combined with vitrectomy.

关 键 词：晶状体脱位 青光眼/治疗 玻璃体切除术 激光凝固术 

分 类 号：R779.63[医药卫生—眼科]