超全视网膜光凝或冷凝结合巩膜池小梁切除术治疗新生血管性青光眼  

Extra-panretinal photocoagulation or retinal cryocoagulation combined with sclera pool trabeculectomy in treating neovascular glaucoma

作　　者：范洪雨[1] 祁艳华[1] 许利娟[1] 郭志强[1] 

机构地区：[1]河北省南皮县人民医院眼科,061500

出　　处：《实用防盲技术》2015年第3期107-110,112,共5页Journal of Practical Preventing Blind

摘　　要：目的探讨中、晚期新生血管性青光眼的治疗方法及疗效。方法对中、晚期新生血管性青光眼29例(30眼),根据屈光间质情况分成光凝组和冷凝组,分别行超全视网膜光凝或全视网膜冷凝治疗,再结合行巩膜池小梁切除术,术后观察两组患者的视力、眼压、虹膜新生血管消退情况及并发症等。结果术后随访6-18个月,平均(10.2±3.65)月。术后所有患者眼痛、头痛症状消失。光凝组16例,17眼,术后14眼眼压控制在21mm Hg(1mm Hg=0.133k Pa)以下,手术成功率82.4%,3眼需加用药物控制后眼压<25mm Hg,术后视力提高8眼(47.1%),15眼虹膜新生血管消退,2眼部分消退,残存数根干瘪的新生血管,冷凝组:13眼,术后10眼眼压控制在正常范围,手术成功率为76.7%,2眼需加用药物治疗,1例出现眼球萎缩。术后视力提高3眼(23.1%),11例虹膜新生血管完全消退,2例部分消退。结论超全视网膜光凝或冷凝结合巩膜池小梁切除术是治疗中、晚期新生血管性青光眼的有效方法,适于基层医院开展。Objetive To explore the treatment and curative effect of neovascular glaucoma. Methods According to the situation of refractive media, 29 cases （30 eyes） of neovascular glaucoma were divided into photocoagulation group and cryocoagulation group. Extra-panretinal photocoagulation or retinal cryocoagulation was performed in the two groups separately, and then combined with trabeculectomy. The visual acuity, intraocular pressure, iris neovascularization fade and complications of the two groups were monitored after operation. Results After operation, patients were followed up from 6 to 18 months. All patients＇ sore eye and headache disappeared. In 17 eyes of photocoagulation group, 14 eyes＇ intraocular pressure were controlled below 21 mmHg （lmmHg = 0.133kPa）, the success rate was 82.4%, 3 eyes.,＇ intraoeular pressure were controlled below 25 mmHg combined with drug treatment; 8 eyes＇ visual acuity were improved（47.1%）; 15 eyes＇ iris neovascularization faded away, 2 eyes＇ iris neovascularization faded partly. In 13 eyes of condensation group, 10 eyes＇ intraocular pressure were controlled in the normal range, the success rate was 76.7%, 2 eyes＇ intraocular pressure control need to combine with drug treatment, 1 eye result in eyeball atrophy; 3 eyes＇ visual acuity were improved（23.1%）; 11 eyes＇ iris neovascularization faded away, 2 eyes＇ iris neovascularization faded partly. Conclusions Extra-panretinal photocoagulation or retinal cryocoagulation combined with trabeculectomy is effective in the treatment of neovascular glaucoma, and suitable for primary hospitals.

关 键 词：新生血管性青光眼 超全视网膜光凝 视网膜冷凝 巩膜池小梁切除术 

分 类 号：R779.63[医药卫生—眼科]