泛视网膜冷凝或光凝联合复合式小梁切除术治疗新生血管性青光眼  

Panretinal cryocoagulation or photocoagulation combined with trabeculectomy for neovascular glaucoma

作　　者：张海江[1] 董洁玉[1] 吴昊[1] 霍鸣[1] 

机构地区：[1]三峡大学第一临床医学院宜昌市中心人民医院眼科, 湖北宜昌443003

出　　处：《中华眼外伤职业眼病杂志》2013年第7期540-542,共3页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨晚期新生血管性青光眼的治疗方案及治疗效果。方法收集晚期新生血管性青光眼28例（28眼），根据屈光间质情况选择泛视网膜冷凝或泛视网膜光凝，再联合复合式小梁切除术，分别观察各组术后眼压、视力、虹膜新生血管消退情况及并发症等。结果术后随访3—24个月，平均（5．8±2．4）月。泛视网膜冷凝组16例，泛视网膜光凝组12例。前者术后眼压12例控制正常，手术成功率75．0％（12／16）。术后视力提高4例，虹膜新生血管全部消退，1例术中发生脉络膜下爆发性出血，2例术后发生增生性玻璃体视网膜病变导致视网膜脱离；后者术后眼压8例控制正常，手术成功率66．7％（8／12）。术后视力提高8例，7例虹膜新生血管全部消退，无严重并发症发生。结论泛视网膜冷凝或光凝联合复合式小梁切除术治疗晚期新生血管性青光眼是一种简单可靠的办法，在基层医院会受到欢迎。Objective To explore the treatment strategy for neovascular glaucoma. Methods The medical records of 28 eyes of 28 eases with neovascular glaucoma were analysed. Panretinal eryoeoagulation or photocoagulation was chosen based on the degree of opacity of ocular media. Then the patients underwent trabeculeetomy. The intraoeular pressure, visual acuity, regression of iris neovascularization and complica- tions were observed. Results The average follow up was 5.8 ~ 2.4 months （ range 3 ~ 24 months）. There were 16 eases treated by panretinal eryocoagulation combined with trabeculectomy （group A）. Of those 16 cases, 12 cases had normal intraocular pressure after treatment. The success rate was 75.0%. The visual a- cuities were improved in 4 cases. Complete regression of iris neovascularization had been noted in all cases in group A. One case had explosive choroidal hemorrhage during the operation. Two cases are complicated with proliferative vitreoretinopathy which later caused retinal detachment. There were 12 cases treated by panretinal photocoagulation combined with trabeculectomy （group B）. In this group, 8 eases obtained con- trolled intraocular pressure and the success rate was 66.7%. 8 cases had better visual acuities. Complete re- gression of iris neovascularization had been noted in 7 cases in group B. No severe complications were ob- served in this group. Conclusion Panretinal eryocoagulation or photocoagulation combined with trabecu- lectomy is an easy and reliable method in the management of neovascular glaucoma which will be popular in rural hospitals.

关 键 词：青光眼 新生血管性 泛视网膜冷凝 泛视网膜光凝 小梁切除术 丝裂霉素C 

分 类 号：R779.6[医药卫生—眼科]