玻璃体切除术联合睫状体光凝治疗外伤性青光眼  

Clinical efficacy and safety of vitrectomy combined with cyclophotocoagulation in treatment of traumatic glaucoma

作　　者：叶国宁 田朋飞 张敏[1] 杨苏云 

机构地区：[1]浙江衢化医院眼科,中国浙江省衢州市324000

出　　处：《国际眼科杂志》2018年第3期556-558,共3页International Eye Science

摘　　要：目的:分析玻璃体切除术联合睫状体光凝治疗外伤性青光眼患者的临床疗效和安全性,旨在为改善外伤性青光眼患者的生活质量提供有效的治疗方式。方法:选取我院2011-01/2016-07收治的90例90眼外伤性青光眼患者,将患者按照不同治疗方式分为两组(每组45眼),观察组患者采用玻璃体切除术联合直视下睫状体光凝治疗,对照组患者采用玻璃体切除术联合经巩膜睫状体光凝治疗。观察不同治疗方式对两组患者视力、眼压和手术并发症发生情况的影响。结果:观察组患者视力改善情况明显优于对照组,差异有统计学意义(Z=-5.689,P<0.05)。两组患者手术治疗前眼压比较,差异无统计学意义(P>0.05);手术结束后观察组患者眼压下降程度低于对照组,差异有统计学意义(P<0.05);对患者随访1a后,两组患者末次随访与术前眼压下降程度比较,差异无统计学意义(P>0.05)。两组患者治疗后均出现玻璃体积血、脉络膜脱落、低眼压、眼压升高等并发症,但两组患者并发症总发生率比较,差异无统计学意义(χ2=1.553,P=0.213)。结论:玻璃体切割联合直视下睫状体光凝术比经巩膜睫状体光凝术后视力提高更理想。AIM:To analyze the clinical efficacy and safety of vitrectomy combined with cyclophotocoagulation in the treatment of traumatic glaucoma,and to provide an effective treatment for improving the quality of life of patients with traumatic glaucoma.METHODS:Totally 90 patients(90 eyes) with traumatic glaucoma admitted in our hospital from January 2011 to July 2016 were divided into two groups(45 patients in each group) according to different treatment methods.The patients in the observation group underwent vitrectomy combined with cyclophotocoagulation under direct vision;the control group underwent vitrectomy combined with trans-scleral cyclophotocoagulation.We observed the effect of different treatment on visual acuity,intraocular pressure and complication of the two groups.RESULTS:The visual acuity of the observation group was significantly better than that of the control group after treatment(Z=-5.689,P<0.05).There was no significant difference on intraocular pressure between the two groups before treatment(P > 0.05).The change of decreased intraocular pressure in the observation group was less than that in the contral group after operation(P<0.05).After 1 a follow-up,there was no significant difference on the change of decreased intraocular pressure between the two groups(P > 0.05).The complications of the two groups after treatment were vitreous hemorrhage,choroidal detachment,low intraocular pressure,increased intraocular pressure and other complications,but the complication rate of two groups were no different(χ~2 =1.553,P=0.213). CONCLUSION:Vitrectomy combined with cyclophotocoagulation under direct vision brings patients better visual acuity than that combined with trans-scleral cyclophotocoagulation.

关 键 词：玻璃体切除术 直视下睫状体光凝治疗 经巩膜睫状体光凝治疗 外伤性青光眼 

分 类 号：R779.6[医药卫生—眼科]