内窥镜下睫状体冷凝术与睫状体光凝术对难治性青光眼患者的治疗效果对比  

Endoscopic cyclocryotherapy versus endoscopic cyclophotocoagulation in the treatment of refractory glaucoma

作　　者：陈京霞 邹秀兰 陈轩阁 俞永珍 周文杰 张楚 邹玉平 CHEN Jingxia;ZOU Xiulan;CHEN Xuange;YU Yongzhen;ZHOU Wenjie;ZHANG Chu;ZOU Yuping(The First School of Clinical Medicine,Southern Medical University,Guangzhou 510515,Guangdong Province,China;Department of Ophthalmology,General Hospital of Southern Theatre Command of PLA,Guangzhou 510010,Guangdong Province,China)

机构地区：[1]南方医科大学第一临床医学院,广东省广州市510515 [2]中国人民解放军南部战区总医院眼科,广东省广州市510010

出　　处：《眼科新进展》2020年第10期942-945,共4页Recent Advances in Ophthalmology

基　　金：广东省自然科学基金项目(编号:2019A1515011732)。

摘　　要：目的比较内窥镜下睫状体冷凝术(endoscopic cyclocryotherapy,ECC)及内窥镜下睫状体光凝术(endoscopic cyclophotocoagulation,ECP)治疗难治性青光眼的效果及安全性。方法收集2014年6月至2019年8月我院就诊的难治性青光眼患者36例(36眼),按手术方式分成2组,其中ECP组22例,ECC组14例。记录术前及术后1周、6个月两组患者的最佳矫正视力、Goldmann眼压、并发症等情况,对两种治疗方法有效性及安全性进行比较。结果末次随访时,两组患眼视力改善率间差异无统计学意义(P>0.05)。ECC组患眼术后1周和6个月眼压从术前(48.37±9.42)mmHg(1 kPa=7.5 mmHg)分别下降至(21.35±8.18)mmHg和(17.79±4.68)mmHg,ECP组患眼术后眼压从术前(45.71±6.16)mmHg分别降至(19.49±5.83)mmHg及(18.63±5.01)mmHg,两组患眼术后1周、6个月眼压均明显低于术前,差异均有统计学意义(均为P<0.01),但术后1周、6个月两组间眼压比较差异均无统计学意义(均为P>0.05)。术后1周手术成功率ECC组(57.1%)低于ECP组(72.7%)(P<0.05),术后6个月两组手术成功率(ECC组为78.6%,ECP组为77.3%)差异无统计学意义(P>0.05)。两组均未出现晶状体脱位及持续性低眼压等严重并发症。结论ECC和ECP在治疗难治性青光眼方面均有较好的效果及安全性。Objective To compare the efficacy and safety of endoscopic cyclocryotherapy(ECC)and endoscopic cyclophotocoagulation(ECP)in the treatment of refractory glaucoma.Methods Thirty-six consecutive patients(36 eyes)with refractory glaucoma received ECC or ECP from June 2014 to August 2019 were reviewed.The patients were divided into 2 groups,22 patients in ECP group and 14 patients in ECC group.The best corrected visual acuity,Goldman intraocular pressure(IOP),and complications of the two groups of patients were recorded before and 1 week and 6 months after the operation,and the effectiveness and safety of the two treatment methods were compared.Results At the last follow-up,there was no significant difference in vision improvement rate between the two groups(P>0.05).In the ECC group,the intraocular pressure decreased from(48.37±9.42)mmHg(1 kPa=7.5 mmHg)preoperatively to(21.35±8.18)mmHg 1 week after treatment and(17.79±4.68)mmHg 6 months after treatment,respectively,while in the ECP group,the IOP was reduced from(45.71±6.16)mmHg to(19.49±5.83)mmHg,(18.63±5.01)mmHg at the same time intervals,and the IOPs of the two groups at 1 week and 6 months after operation were significantly lower than those before the operation,and the difference was statistically significant(all P<0.01),but there was no statistically significant difference in data at 1 week and 6 months after operation(both P>0.05).One week after operation,the success rate of ECC group(57.1%)was lower than that of ECP group(72.7%)(P<0.05),there was no significant difference between ECC group and ECP group 6 months after operation(78.6%vs.77.3%;P>0.05).No crystalline dislocation and persistent low intraocular pressure were found in both groups.Conclusion Both ECC and ECP are proved to be safe and effective methods in treating refractory glaucoma.

关 键 词：内窥镜 睫状体光凝 睫状体冷凝 难治性青光眼 

分 类 号：R775.3[医药卫生—眼科]