前部视网膜冷凝联合小梁切除术治疗新生血管性青光眼的远期疗效观察  

Observation on treatment of neovascular glaucoma by anterior retina condensation and combined with trabeculectomy for a long time

作　　者：王辉[1] 齐景福[1] 

机构地区：[1]天津宝坻区人民医院眼科,天津市301800

出　　处：《眼科新进展》2011年第12期1159-1161,共3页Recent Advances in Ophthalmology

摘　　要：目的探讨前部视网膜冷凝联合小梁切除术治疗新生血管性青光眼的远期疗效。方法对38例(38眼)新生血管性青光眼行前部视网膜冷凝联合小梁切除术,术中使用丝裂霉素C(0.4g·L-1)。观察术后1个月、3个月、6个月、1a、3a、6a的眼压、视力及中晚期并发症情况。结果术后1个月、3个月、6个月、1a、3a、6a的眼压控制率分别为100%、97.37%、92.11%、84.21%、82.26%、82.35%;术后1个月眼压控制率与3个月、6个月比较,差异均无统计学意义(均为P>0.05);3个月与6个月比较,差异无统计学意义(P>0.05),但3个月与1a、3a、6a之间比较,差异均有统计学意义(均为P<0.05);6个月与1a、3a、6a之间比较,差异均无统计学意义(均为P>0.05);1a、3a、6a之间比较,差异无统计学意义(P>0.05)。术后1个月、3个月、6个月时38例中均有12例视力较术前提高,无视力下降者;术后1a时38例中10例视力较术前提高,2例下降;术后3a时29例中6例视力较术前提高,4例下降;术后6a时17例中3例视力较术前提高,5例下降。术后并发症主要是黄斑水肿、黄斑变性、黄斑出血和白内障等。结论前部视网膜冷凝联合小梁切除术治疗新生血管性青光眼,经长期随访证明大部分患者能有效安全控制眼压,部分患者可提高视力,且远期疗效稳定。Objective To explore the therapeutic effect of neovascular glaucoma by anterior retinal condensation and combined with trabeculectomy.Methods About 38 cases（38 eyes） with neovascular glaucoma were treated anterior retinal condensation and trabeculectomy.The 0.4 g·L-1 mytomycin C was used.Intraocular pressure and visual acuity at postoperative 1 month,3 months,6 months,1 year,3 years and 6 years were observed.Results The controlled rates of intraocular pressure were 100%,97.37%,92.11%,84.21%,82.26% and 82.35% at postoperative 1 month,3 months,6 months,1 year,3 years and 6 years.There was no difference in controlled rate at postoperative 1 month compared with those at postoperative 3 months and 6 months（both P0.05）,either between postoperative 3 months and 6 months（P0.05）,while there was statistical differences for that at 3 months compared with 1 year,3 years and 6 years（all P0.05）,no difference was found for 6 months compared with 1 year,3 years and 6 years（all P0.05）,either among 1 year,3 years and 6 years（P0.05）.At postoperative 1 month,3 months and 6 months,visual acuity of 12 cases increased in a total of 38 cases,and visual acuity did not decrease.At postoperative 1 year,visual acuity of 10 cases increased in a total of 38 cases,2 cases decreased;At postoperative 3 years,visual acuity of 6 cases increased in a total of 29 cases and 4 cases decreased;At postoperative 6 years,visual acuity of 3 cases increased in a total of 17 cases and 5 cases decreased.The main postoperative complications were macular edema,macular degeneration,macular hemorrage and cataract.Conclusions Anterior retinal condensation combined with trabeculectomy can be used for neovascular glaucoma.The long follow up shows that it can effectively and safely control intraocular pressure,some patients can improve visual acuity,and long term efficacy is stable.

关 键 词：新生血管性青光眼 视网膜冷凝 小梁切除术 

分 类 号：R775[医药卫生—眼科]