半导体激光经巩膜睫状体光凝术治疗难治性青光眼  

Clinical study of semiconductor laser transscleral cyclophotocoagulation on refractory glaucomatous

作　　者：黄志坚[1] 宋艳萍[1] 丁琴[1] 

机构地区：[1]广州军区武汉总医院全军眼科中心,中国湖北省武汉市430070

出　　处：《国际眼科杂志》2015年第3期537-539,共3页International Eye Science

摘　　要：目的：评价半导体激光经巩膜睫状体光凝术治疗难治性青光眼的临床疗效和安全性。方法：回顾性分析2012-03/2013-03到我院眼科就诊33例33眼难治性青光眼患者临床资料,所有患者均行半导体激光经巩膜睫状体光凝术,激光能量1 000~3 000mW,时间2 000~3 000ms,击射范围270°~360°,击射点20~40点。随访观察并记录患者临床症状、视力、眼压、眼前节及并发症,随访时间为6mo。结果：最后随访时32例（97%）的患者眼部症状明显缓解或消失;术前平均眼压为50.26±9.37mmHg,最后随访6mo时平均眼压下降为18.38±8.73mmHg,治疗前后眼压具有统计学意义（P〈0.05）。2例（6%）术后3mo时眼压再次升高,给予再次激光治疗,术后并发症为前房炎症反应9例（27%）,前房出血5例（15%）,结膜下出血2例（6%）,结膜充血水肿12例（36%）,眼球萎缩1例（3%）。结论：半导体激光经巩膜睫状体光凝术治疗难治性青光眼是一种简便、降压显著、痛苦小、安全有效的方法。AIM： To investigate the safety and effectiveness of semiconductor laser transscleral cyclophotocoagulation（ Tscpc） on refractory glaucomatous.METHODS： A retrospective review of 33 patients（ 33eyes） whose eyes were diagnosed as refractory glaucomatous from March 2012 to March 2013 were treated with Tscpc（ energy 1 000 ~3 000 mW,time 2 000 ~3 000 ms,range 270° ~ 360°, count 20 ~ 40）. Ocular symptoms,visual acuity,and intraocular pressure（ IOP）,ocular protomerite and complications were observed after Tscpc. Patients were followed up 6mo.RESULTS： The pain sense of 32 patients（ 97%）disappeared or remarkably relieved at the final follow up.Mean pre- operative IOP was 50. 26 ± 9. 37 mmHg,which was significantly different from the final follow- up 6mo mean IOP 18. 38 ± 8. 73mmHg（ P〈0. 05）. At three month postoperative,IOP of 2 cases（ 6%） was rise,and those patients were retreated with Tscpc. Complications included inflammation in anterior chamber reaction in 9cases（ 27%）, hyphema 5 cases（ 15%）, conjunctival hemorrhage 2 cases（ 6%）. Bulbar conjunctival congestion and edema 12 cases（ 36%）,and atrophy of eyeball 1 case（ 3%）.CONCLUSION： Semiconductor laser transscleral cyclophotocoagulation is a simple, safe and effective method in the treatment of refractory glaucoma.

关 键 词：半导体激光 经巩膜睫状体光凝术 难治性青光眼 

分 类 号：R779.6[医药卫生—眼科]