玻璃体切割联合睫状突光凝术治疗新生血管性青光眼  

Clinical effect of neovascular glaucoma treated by vitrectomy and cyclophotocoagulation

作　　者：金怡轩[1] 刘斐[1] 

机构地区：[1]南方医科大学附属南海医院眼科,中国广东省佛山市528200

出　　处：《国际眼科杂志》2014年第7期1325-1326,共2页International Eye Science

摘　　要：目的：对需行玻璃体手术且并发新生血管性青光眼的患者进行眼内睫状突光凝术,观察术后眼压控制效果及手术安全性。 方法：回顾12例14眼新生血管性青光眼患者,分别继发于糖尿病性视网膜病变、视网膜脱离术后及眼外伤。本术式主要是在玻璃体切除术后立即采用眼内光凝导管直接对睫状突进行光凝,直到睫状突出现白色萎缩或爆破音为止,曝光时间0.1~0.2ms,能量300~500mW。术后随访6mo,分别于术后1wk；1,6mo观察14只新生血管性青光眼的眼压和并发症情况。 结果：本研究发现11眼眼压出现明显下降至正常范围之内。光凝术后1wk平均眼压为16.7±14.4mmHg,1mo为15.7±8.8mmHg,6mo为12.9±4.5mmHg,与治疗前（39.6±10.0mmHg）相比差异具有统计学意义（P〈0.01）。随访期间3眼再次出现眼压升高,因其不具备再次玻璃体手术适应证而给予了经巩膜或内窥镜下睫状体突光凝术。随访期间患眼未出现眼内炎及眼球萎缩等并发症。 结论：眼内睫状突光凝与玻璃体手术同时进行,可同时处理原发疾病和青光眼。该术式可在直视下准确光凝睫状突,对治疗需要玻璃体切除术的新生血管性青光眼是一种较安全有效的方法。AIM： To observe the postoperative intraocular pressure IOP） and operation safety in the eyes of the neovascular glaucoma pateints treated by intraocuiar cycIOPhotocoagulation which needed vitrectomy at the same time. METHODS： A total of 12 neovascular glaucoma cases （14 eyes） secondary to diabetic retinopathy, retinal detachment surgery and trauma were reviewed in our study. This procedure photocoagulation catheter processes until the ciliary mainly used intraocular to highlight the ciliary became white atrophy or plosion after vitreous surgery treatment. The intraocular photocoagulation catheter was performed at a power of 300-500mW, for a duration of 0.1-0.2ms. Postoperative follow-up was at least for 6mo. The observation of 14 postoperative neovascular glaucoma was performed at lwk, 1, 6mo observing the IOP and complications. RESULTS： IOP of the 11 eyes was significantly declined and controlled in normal. After cycIOPhotocoagulation, average IOP at lwk was 16.7±14.4mmHg, 15.7±8.8mmHg at 1 mo and 12.9±4. 5mmHg at 6mo, which compared with untreatment （39. 6 ±10. 0mmHg） was statistically significant different （ P〈0.01 ）. In follow up time 3 cases were relapsed which were supplied with transscleral or endoscope cycIOPhotocoagulation. During the follow-up period no endophthalmitis and complications such as eyeball atrophy were found, CONCLUSION： The intraocular cycIOPhotocoagulation and vitrectomy simultaneously can deal with the primary disease and secondary neovascular glaucoma. Theoperation can be accurately performed under direct cycIOPhotocoagulation and it is a safe and effective way for neovascular glaucoma which needs vitreous surgery.

关 键 词：睫状突光凝 玻璃体手术 新生血管性青光眼 

分 类 号：R779.6[医药卫生—眼科]