内窥镜引导睫状突光凝治疗外伤继发青光眼  

Clinical research on endoscopic cyclophotocoagulation in the treatment for post-traumatic secondary glaucoma.

作　　者：郑鹏飞[1] 庞秀琴[1] 何雷[1] 杨勋[1] 李琦琰[1] 

机构地区：[1]首都医科大学北京同仁医院眼科中心,北京100730

出　　处：《眼外伤职业眼病杂志》2005年第11期819-821,共3页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的评价内窥镜引导睫状突光凝治疗外伤性继发性青光眼的有效性和安全性.方法选择需联合玻璃体、晶状体手术的外伤性继发性青光眼31例(31眼),应用内窥镜引导睫状突光凝术进行治疗(A组).收集已应用传统抗青光眼手术治疗的条件相当的外伤性青光眼病例作为对照,其中引流物植入术(B组)20例(20眼),小梁切除联合MMC术(C组)23例(23眼).各组患者术后随访6月以上.以无需全身应用降眼压药物,眼压6～21mmHg,且无其它严重术后并发症作为判断手术成功标准.结果患者平均随诊时间为:A组14月,B组19月,C组17个月.A组术前平均眼压为(34.80±15.95)mmHg,术后降至(21.38±10.86)mmHg;手术成功率为80.66%,与B组(80.00%)相当,优于C组(52.17%);并发症发生率为22.58%,低于B组(50.00%)和C组(65.22%).且无持续性低眼压、眼球痨或严重视功能下降等严重并发症发生.结论内窥镜睫状突光凝术成功率较高,并发症较少.对于外伤性继发性青光眼,特别是需联合玻璃体及晶状体手术者,优于传统抗青光眼手术.Objective To evaluate the safety and efficacy of endoscopic cyclophotocoagulation in the treatment of post-traumatic glaucoma. Methods 31 patients （31 eyes） with post-traumatic glaucoma were treated with endoscopic cyclophotocoagulation as the study group （group A）.At the same time all patients underwent the lens extraction and vitrectomy because of other traumatic complications. The patients in the control group were hospitalized before the end of September in 2002, and they were treated with the traditional anti-glaucoma operations, including Ahmed valve implant （group B, 20 eyes） and trabeculeetomy （group C, 23 eyes）. The criteria of the operation success included that the post-treatment IOP was between 5 and 21mmHg （without systemic medication to control the lOP）, and there were no serious complications. All patients were followed up for at least six months, except for accepted another operation in order to deal with the complications. Results The mean follow-up time of each group were 14 months （group A）, 19 months （group B）,and 17 months （group C） respectively.The post-operative IOP of the endoscopic cyclophotocoagulation group （study group） was （21.38± 10.86）mmHg compared with （34.80 ± 15.95） mmHg of pre-operation IOP. The success rate in the group A was 80.66% （25/31） ,which was equivalent to 80% （16/ 20） in the group B and statistically significant better than 52.17% （12/23） in group C. The complication rate of group A, B, C were 22.58% （7/31） ,50% （ 10/20）, 62.22% （ 15/23 ） respectively. The statistical analysis showed the complication rate of group A was the least of all groups. Conclusion Endoscopic cyclophotocoagulation is a safe and effective method to treat traumatic glaucoma, especially for the cases needed lens and vitreous operations simultaneously.

关 键 词：内窥镜 睫状突光凝 外伤继发青光眼 

分 类 号：R779.63[医药卫生—眼科]