经巩膜睫状体光凝与睫状体冷冻治疗绝对期青光眼的疗效比较  

Comparison the curative effect of trans-scleral cyclophotocoagulation versus cyclocryotherapy in the treatment of absolute glaucoma

作　　者：王蕊[1] 杨瑾[1] 尹泽琳 田晓峰[1] 曲乐 许丹 Rui Wang;Jin Yang;Ze-Lin Yin;Xiao-Feng Tian;Yue Qu;Dan Xu(Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin 300020, China)

机构地区：[1]中国天津市眼科医院天津市眼科学与视觉科学重点实验室天津市眼科研究所,300020

出　　处：《国际眼科杂志》2021年第4期604-612,共9页International Eye Science

摘　　要：目的:探讨经巩膜二极管睫状体光凝(CPC)与睫状体冷冻(CCT)对绝对期青光眼的降眼压(IOP)效果及术后并发症的比较。方法:前瞻性病例观察研究。纳入天津市眼科医院收治的绝对期青光眼85例,随机分成两组行CPC或CCT手术治疗,观察术前,术后1、3d,1、2wk,1、3、6mo的IOP、抗青光眼药物数量、眼前节炎症反应,利用视觉模拟评分标准(VAS)评价术后眼球疼痛感。比较手术前后的所有指标及两种手术方式成功率的差异。结果:与CPC组相比,CCT组的IOP在术后1、3d,1、2wk,1mo较术前下降少,VAS评分在术后3d,1、2wk,1mo较术前下降少,抗青药物数量对数值在术后1、3d,1、2wk较术前下降少(P<0.05)。与CPC组相比,CCT组术后3d,1、2wk,1、3、6mo完全成功率较术后1d升高,但只有术后3、6mo有差异(P<0.05)。与CPC组相比,CCT组前房闪辉分级在术后3d,1、2wk,1mo较术前上升更多,结膜充血分级在术后1、3d,1、2wk较术前上升更多,角膜水肿分级在术后3d,1、2wk,1mo较术前上升更多,炎症反应更重(P<0.05)。结论:与CPC相比,CCT术后降IOP速度较慢,眼前节反应及眼部疼痛感较重且持续时间较长,术后需将抗炎药物及抗青光眼药物使用的时间延长。AIM:To compare the effectiveness of diode transscleral cyclophotocoagulation(CPC)and transscleral cyclocryotherapy(CCT)for the intraocular pressure(IOP)control and postoperative complications of absolute glaucoma.METHODS:This was a prospective case observation study.Totally 85 cases with absolute glaucoma which were admitted by Tianjin Eye Hospital were randomly assigned in 2 groups to receive either CPC or CCT.IOP,the numbers of anti-glaucoma medication,inflammatory reaction of anterior segment and postoperative ocular pain which was evaluated by Visual Analogue Scale(VAS)in two groups were recorded at eight points in time:the day before surgery and 1d,3d,1wk,2wk,1mo,3mo and 6mo after surgery.The generalized estimated equation was used to compare all the indexes before and after operation and the difference of success rate between the two surgical methods.RESULTS:Compared with CPC group,IOP of CCT group decreased less than that before surgery at 1,3d,1,2wk,1mo after surgery,VAS score decreased less than that before surgery at 3d,1,2wk,1mo after surgery,and the number of anti-glaucoma drugs decreased less than that before surgery at 1,3d,1,2wk after surgery(P<0.05).Compared with CPC group,the complete success rate of CCT group was higher than that at 1d after surgery at 3d,1,2wk,1,3,6mo after operation,but only the difference of 3,6mo after surgery was statistically significant(P<0.05).Compared with CPC group,anterior chamber flash grade of CCT group increased more than that before surgery at 3d,1,2wk,1mo after surgery,conjunctival congestion grade increased more than that before surgery at 1,3d,1,2wk after surgery,corneal edema grade increased more than that before surgery at 3d,1,2wk,1mo after surgery(P<0.05).CONCLUSION:Compared with CPC,the rate of IOP reduction after CCT was slower,the inflammatory reaction of anterior segment and discomfort of eyeball were more severe and lasted longer.Therefore,the duration of anti-inflammatory drugs and anti-glaucoma medications should be extended after the surgery.

关 键 词：睫状体光凝术 睫状体冷凝术 绝对期青光眼 

分 类 号：R47[医药卫生—护理学]