半导体二极管激光经巩膜睫状体光凝术治疗难治性青光眼的临床疗效分析  

Efficacy and safety of semiconductor diode laser transscleral photocoagulation for the treatment of refractory glaucoma

作　　者：梁亚 嵇芳芳 帅捷 Sucijanti 袁志兰 LIANG Ya;JI Fang-Fang;SHUAI Jie;YUAN Zhi-Lan(Department of Ophthalmology,the Jiangsu Province Hospital,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,Jiangsu Province,China)

机构地区：[1]江苏省人民医院,南京医科大学第一附属医院眼科,江苏省南京市210029

出　　处：《眼科新进展》2019年第2期141-144,共4页Recent Advances in Ophthalmology

基　　金：国家自然科学基金面上项目(编号:81271001)~~

摘　　要：目的回顾性分析半导体二极管激光经巩膜睫状体光凝术(semiconductor diode laser transscleral photocoagulation,TSCPC)治疗难治性青光眼的有效性和安全性。方法收集2015年1月至2017年4月在江苏省人民医院眼科接受TSCPC治疗的难治性青光眼患者;记录并分析患者的一般资料,包括病因、激光能量、视力、术前及术后不同时间点的眼压、用药种类和炎性反应、手术成功率以及并发症等。结果本研究共纳入患者54例(54眼),随访时间为(13. 7±4. 2)个月,使用的激光能量为(112. 7±31. 0) J。TSCPC术后1a手术完全成功率为72. 2%,相对成氉功率为85. 2%;眼压由术前的(42. 4±10. 0) mmHg(1 kPa=7. 5 mmH g)降至术后的(13. 3±5. 8) mmH g,用药种类由术前的(2. 68±0. 83)种减少至术后的(0. 15±0. 43)种;术后1 d、1周、1个月、3个月、6个月、9个月、12个月的眼压和用药种类与术前相比差异均有统计学意义(均为P <0. 05)。TSCPC对新生血管性青光眼的降眼压效果优于原发性闭角型青光眼,差异有统计学意义(P=0. 04)。5眼(9. 3%)发生了并发症,其中持续的炎性反应2眼(3. 7%)。结论TSCPC能够安全有效地降低难治性青光眼患者的眼压,并且减少用药种类。Objective To analyze the efficacy and safety of semiconductor diode laser transscleral photocoagulation(TSCPC)for the treatment of refractory glaucoma in this retrospective study.Methods Patients with refractory glaucoma who received TSCPC in the Ophthalmology Department of Jiangsu Province Hospital from January 2015 to April 2017 were collected.General information,including etiology,laser energy,vision acuity,preoperative and postoperative intraocular pressure and types of medications,inflammation,success rates,and complications were recorded.Results These retrospective study participants included 54 patients(54 eyes).Average follow-up was(13.7±4.2)months and the laser energy was(112.7±31.0)J.The complete success rate of one year after TSCPC was 72.2%,and the qualified success rate was 85.2%.Intraocular pressure decreased from(42.4±10.0)mmHg(1 kPa=7.5 mmHg)before surgery to(13.3±5.8)mmHg one year after surgery,and the types of anti-glaucoma medications was reduced from 2.68±0.83 before surgery to(0.15±0.43)one year after surgery.There was a statistically significant difference in intraocular pressure and the number of medications used between preoperatively and at each time point postoperatively(all P<0.05).TSCPC had a better effect on neovascular glaucoma than primary angle closure glaucoma,with significant difference(P=0.04).Complications occurred in 5 eyes(9.3%),including 2 eyes(3.7%)with consistent inflammation.Conclusion TSCPC can safely and effectively reduce the intraocular pressure and number of medications.

关 键 词：经巩膜睫状体光凝术 难治性青光眼 眼压 

分 类 号：R775.9[医药卫生—眼科]