新生血管性青光眼的病因分析和手术治疗  

Etiological analysis and surgical treatment ofneovascular glaucoma

作　　者：王建民[1] 马景学[1] 叶存喜[1] 黄灵欣[1] 盛孟怡[1] 

机构地区：[1]河北医科大学第二医院眼科,石家庄050000

出　　处：《中国实用眼科杂志》2008年第6期587-590,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨新生血管性青光眼（neovascular glaucoma，NVG）的原发病因和手术治疗方案的选择。方法对NVG患者97例108只眼的病因和手术资料进行分析总结。结果在所有的患者中，视网膜静脉阻塞导致NVG的患者最多，其次为糖尿病视网膜病变；两者之合共67例74只眼，占总例数的69．1％，总眼数的68．5％。其他的病因包括眼缺血综合征5例6只眼，Coat病4例4只眼，慢性色素膜炎3例4只眼，慢性闭角型青光眼3例3只眼，以及一些相对少见的病因。37只眼接受或者补充完成了全视网膜光凝治疗，其中34只眼（91．9％）新生血管完全消退。47只眼接受了全周边视网膜冷凝治疗，其中38只眼（80．9％）的新生血管完全消退。在接受改良式小梁切除、术前或术后全视网膜光凝治疗的26只眼中，21只眼（80．8％）的眼压控制良好。在接受玻璃体切除＋全视网膜光凝＋小梁切除术的9只眼中，8只眼（88．9％）眼压控制良好。4只眼接受青光眼阀植入手术，在平均5．5月随访期内眼压控制良好。39只眼先后接受52次半周睫状体冷冻术，其中30只眼（76．9％）眼压控制良好。结论NVG的病因复杂多样，手术治疗应该根据不同的临床特点制定个体化的治疗方案。Objective To investigate the etiology and surgical treatment of neovascular glaucoma （NVG）.Methods The etiological and surgical data of 108 eyes of 97 NVG patients were analyzed and summarized. Results Of all the causes,retinal vein occlusion was the principal cause,followed by diabetic retinopathy, and their sum were 74 eyes of 67 patients, 69.1% of all patients and 68.5% of all NVG eyes. The other causes included ocular ischemia syndrome （ 6 eyes of 5 patients ）, Coat＇s disease （ 4 eyes of 4 patients ）, chronic uveitis （ 4 eyes of 3 patients ）, chronic angle-closure glaucoma （ 3 eyes of 3 patients ） , and some relatively unusual causes. Of 37 eyes performed panretinal photocoagulation, the new vessels of 34 eyes （ 91.9% ） were disappear, of 47 eyes performed pan-peripheral retinal cryotheraphy, the new vessels of 38 eyes （80.9%） were disappear, of 26 eyes performed improved trabeculectomy with preoperative or postoperative panretinal photocoagulation, the intraocular pressures （ IOP ） of 21 eyes （ 80.8% ）were fully controlled. Of 9 eyes performed vitrectomy and panretinal photocoagulation and trabeculectomy, the IOP of 8 eyes （ 88.9% ） were fully controlled. All 4 eyes performed glaucoma drainage implant placement appeared fully controlled IOP during the average follow-up time of 5.5 months. Of 39 eyes performed 52 semicircular ciliary body cryotheraphies early or late, the lOP of 30 eyes （76.9%） were fully controlled. Conclusions The causes of NVG are complicated and various, and the individual operation should be performed according to various clinical characteristic.

关 键 词：新生血管性青光眼 病因学 手术治疗 

分 类 号：R775[医药卫生—眼科] R442.5[医药卫生—临床医学]