前部视网膜冷凝联合玻璃体切除术治疗中早期NVG  

Treatment of neovascular glaucoma by anterior retina condensation in combination with pars plana vitrectomy

作　　者：肖丽波[1] 薛黎萍[1] 李云琴[1] 韦春玲[1] 

机构地区：[1]云南省第二人民医院眼科,中国云南省昆明市650021

出　　处：《国际眼科杂志》2011年第1期128-129,共2页International Eye Science

基　　金：中国云南省科技厅昆明医学院联合专项基金资助项目(No.2009C135)~~

摘　　要：目的：探讨前部视网膜冷凝联合玻璃体切除术治疗中早期新生血管青光眼（neovascular glaucoma, NVG）的临床效果。方法：采用前部视网膜冷凝联合玻璃体切除术治疗中早期新生血管青光眼31例31眼，术中全视网膜光凝。结果：患者31眼,术前眼压41.1±6.2mmHg,术后观察3~25（平均9.8）mo，眼压22.6±6.9mmHg,术前术后眼压差别具有统计学意义（P=0.002）；25例眼压控制正常，眼压19.8±24mmHg，6例眼压34±8.2mmHg,其中3例局部药物治疗眼压控制正常，2例行二次手术，玻璃体腔青光眼阀植入术后，眼压控制满意，1例无效，患眼无光感，疼痛，行眼内容摘除术。20眼视力有不同程度的提高，5例视力不变，5例视力下降，1例无光感。30例虹膜面新生血管绝大部分或完全消退，角膜透明，前房无积血，所有病例眼部疼痛消失或明显缓解。结论：前部视网膜冷凝联合玻璃体切除术可消退虹膜面的新生血管，有利于术后眼压的控制，恢复部分视力，为中早期新生血管性青光眼提供了一个行之有效的治疗方案。AIM： To evaluate the effect of the treatment of neovascular glaucoma（NVG） by anterior retina condensation in combination with pars plana vitrectomy.METHODS： Tirty-one cases 31 eyes with diagnosed NVG were treated by anterior retina condensation in combination with pars plana vitrectomy, and whole-retina photocoagulation was applied as well.RESULTS： Preoperative intraocular pressure （IOP） was 41.1±6.2mmHg, after 3-25 months follow-up （average 98 months）,the average of IOP was 22.6±6.9mmHg. There was statistical difference between IOP before and after operation. 25 eyes IOP was controlled to be normal （19.8±2.4mmHg）; 3 eyes needed topical anti-glaucoma drops, and 2 eyes were carried out glaucoma valve implantation. 1 eye was applied evisceration because of no light perception and eye-pain after operation. 20 cases got a better visual acuity, 5 cases remained the same level, 5 cases decreased, and 1 case became no light perception. Neovascular on the surface of iris almost or completely disappeared in 30 cases, maintaining corneal transparency and non hematocele anterior chamber. Most follow-up cases eye-pain disappeared or obviously reliever.CONCLUSION： Treatment of anterior retina condensation in combination with pars plana virrectomy is effective in neovascular glaucoma. It can lead to better visual acuity, disappearance of iris neovessels, and decrease of IOP.

关 键 词：新生血管性青光眼 前部视网膜冷凝 玻璃体切除术 全视网膜光凝 

分 类 号：R779.6[医药卫生—眼科]