青光眼引流阀植入联合视网膜激光光凝治疗新生血管性青光眼  

Clinical effect of glaucoma drainage device implant and retinal photocoagulation in treatment of neovascular glaucoma

作　　者：杨贺斌 

机构地区：[1]湖北省襄阳市襄州区人民医院眼科,410001

出　　处：《眼科新进展》2011年第11期1053-1055,共3页Recent Advances in Ophthalmology

摘　　要：目的观察青光眼引流阀植入联合视网膜激光光凝治疗新生血管性青光眼的临床疗效。方法回顾性分析2007年6月至2010年6月在我院眼科确诊并行青光眼引流阀植入联合视网膜激光光凝治疗的新生血管性青光眼患者27例(27眼),记录术前、术后1周、1a的眼压、视力、并发症等,并检测患者视野、角膜内皮细胞丢失及滤过泡情况。结果 27例患者一次手术成功率为100.0%;术后1周,完全成功率55.6%,部分成功率为29.6%;术后1a完全成功率48.1%,部分成功率33.3%。术前平均眼压为(50.2±10.3)mmHg(1kPa=7.5mmHg),术后1周平均(13.0±8.6)mmHg,术后1a平均(14.1±7.9)mmHg,与术前相比差异均具有显著统计学意义(均为P<0.01)。术后1周视力有所提高者15例,不变者12例;术后1a视力有所提高者17例,不变者10例。术前角膜内皮细胞计数平均2328.5mm-2,术后1周为2298.7mm-2,与术前相比差异无统计学意义(P>0.05);术后1a平均为2009.2mm-2,与术前相比差异有统计学意义(P<0.05),术后1a角膜内皮丢失率为13.8%。早期术后并发症有滤过作用过强、前房出血等,所有患者未见引流管口暴露、角膜内皮失代偿等并发症发生。结论青光眼引流阀植入联合视网膜激光光凝治疗新生血管性青光眼疗效确切,可以有效控制眼压,并降低术后并发症的发生,是一种治疗新生血管性青光眼的理想方法。Objective To investigate the clinical effect of glaucoma drainage device implant and retinal photocoagulation in treatment of neovascular glaucoma.Methods About 27 patients（27 eyes） with neovascular glaucoma were collected in our hospital from June 2007 to June 2010.All patients underwent the glaucoma drainage device implant and retinal photocoagulation.The visual acuity,intraocular pressure and complications were recorded before operation and at 1 week,1 year after operation,visual field,corneal endothelial loss and filtering bleb were detected.Results The rate of once operation success was 100.0%.At 1 week after operation,the total success rate was 55.6%,and the part success rate was 29.6%.At 1 year after operation,the total success rate was 48.1%,and the part success rate was 33.3%.The average intraocular pressures were（50.2±10.3）mmHg（1 kPa=7.5 mmHg） before operation,（13.0±8.6）mmHg at 1 week after operation,and（14.1±7.9）mmHg at 1 year after operation,which had statistical differences compared with that before operation（all P〈0.01）.The visual acuity improved in 15 cases,and unchanged in 12 cases at 1 week after operation.The visual acuity improved in 17 cases,and unchanged in 10 cases at 1 year after operation.The corneal endothelial cell numbers were 2 328.5 mm-2 before operation,2 298.7 mm-2 at 1 week after operation,there was no statistical difference（P〉0.05）;It was 2 009.2 mm-2 at 1 year after operation,there was statistical difference compared with that of before operation（P〈0.05）.The corneal endothelial cells loss rate was 13.8% at 1 year after operation.The major complications after operation were high hypertension and hyphema.Severe complications,such as exposure of tube,corneal decompensation,were not observed.Conclusion Glaucoma drainage device implant and retinal photocoagulation are ideal treatment of neovascular glaucoma,which can not only decrease the intraocular pressure,but avoid the complications,so this therapy can lead to an ideal effect.

关 键 词：青光眼引流阀植入 视网膜激光光凝 新生血管性青光眼 

分 类 号：R775[医药卫生—眼科]