前部视网膜冷凝联合小梁切除术治疗新生血管性青光眼  

Treatmentofneovascularglaucomabyanteriorretinalcryotherapyandtrabculectomy

作　　者：马立[1] 赵本严[1] 狄雅芬[1] 

机构地区：[1]北京医院眼科

出　　处：《中华眼科杂志》1996年第2期118-122,共5页Chinese Journal of Ophthalmology

摘　　要：目的观察前部视网膜冷凝术（ａｎｔｅｒｉｏｒｒｅｔｉｎａｌｃｒｙｏｔｈｅｒａｐｙ，ＡＲＣ）对开角型新生血管性青光眼及ＡＲＣ联合小梁切除术对闭角型新生血管性青光眼的疗效。方法对１１例（１２只眼）开角型新生血管性青光眼单独行ＡＲＣ，２２例（２２只眼）闭角型新生血管性青光眼行ＡＲＣ联合小梁切除术；另选３１例（３２只眼）闭角型新生血管性青光眼单独行ＡＲＣ或睫状体冷凝术作对照。随访６～２６个月。结果单独行ＡＲＣ可使９２％（１１／１２）的开角型新生血管性青光眼眼压恢复正常，虹膜新生血管消退，与单独行ＡＲＣ的闭角型新生血管性青光眼比较，差异有显著性（Ｐ＜０．０５）。对闭角型新生血管性青光眼，行ＡＲＣ联合小梁切除术，可使８６％（１９／２２）的患者眼压恢复正常，虹膜新生血管消退，明显优于仅行ＡＲＣ或睫状体冷凝术者（Ｐ＜０．０１）。此联合术式可使９０％（１８／２０）的患者眼痛消失，６７％（８／１２）的患者视力保持，与睫状体冷凝术比较，差异有显著性（Ｐ＜０．０５）。结论认为ＡＲＣ单独应用可治疗早期新生血管性青光眼，晚期患者需联合小梁切除术治疗。ObjectiveToinvestigatetheeficacyofanteriorretinalcryotherapy(ARC)fortreatmentofneovascularglaucoma(NVG).Methods12eyes(11patients)withopenangleNVGweretreatedbyARConly,22eyes(22patients)withclosedangleNVGweretreatedbyARCcombinedwithtrabeculec-tomy,and32eyes(31patients)withclosedangleNVGweretreatedbyeitherARCorcyclocryotherapyascontrols.Thefolow-uppreiodswere6～26months.ResultsIrisnewvessels(INV)regressedordis-appearedwithnormalintraocularpressure(IOP)in92%(11/12)oftheeyeswithopenangleNVGtreatedsimplybyARC.IncomparisonwithclosedangleNVGtreatedbythesamemethod,therewasasignifi-cantdiferenceinIOP(P<0.05).ThecombinationofARCandtrabeculectomyshowedmarkedlybetterresultsthaneitherARCorcyclocryotherapyfortreatmentofclosedangleNVG(P<0.01).IntheeyeswithclosedangleNVG,INVregressedordisappearedwithnormalIOPin86%(19/22),90%(18/20)achievedamarkedrelieffrompainandthevisualacuitywasbeterorunchangedin67%(8/12)thatwassignificantlydiferentfromtheeyestreatedbycyclocryotherapy(P<0.05).ConclusionTheresultsin-dicatetheARCissuitablefortreatmentofNVGatearlystage,andARCcombinedwithtrabeclectomy,atlaterstage.

关 键 词：青光眼 新生血管性 视网膜冷凝术 小梁切除术 

分 类 号：R775.05[医药卫生—眼科]