内镜下睫状体光凝治疗玻璃体切除术后青光眼的效果  

The efficiency of endoscopic cyclophotocoagulation in the treatment of refractory glaucoma after vitrectomy

作　　者：王平[1] 张丽娟 Wang Ping;Zhang Lijuan(Shanxi Eye Hospital,Taiyuan 030002,China)

机构地区：[1]山西省眼科医院,太原030002

出　　处：《中华眼外伤职业眼病杂志》2021年第3期166-172,共7页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评价内窥镜下睫状体光凝术(endoscopic cyclophotocoagulation,ECP)治疗玻璃体切除术后青光眼的效果。方法回顾性分析2015年5月至2017年12月山西省眼科医院玻璃体切除术后难治性青光眼进行ECP的30例(31只眼)的临床资料。根据光凝范围分为3组,<180°组12只眼,180°~270°组5只眼,>270°组14只眼。观察术后1周~24个月的眼压、视力及光凝范围与术后眼压降幅的关系。结果所有患者术后各时间点眼压均低于术前(F=26.82,P<0.05)。光凝范围越大,降眼压效果越显著,二者呈正相关。末次随访无需任何降眼压药物治疗而眼压正常者22例(70.97%);应用降眼压药物而眼压仍高于21 mmHg者7例(22.58%)。末次随访视力(logMAR)2.40±1.60与术前2.19±1.38比较差异无统计学意义(t=-1.18,P>0.05),随访时间87.10%(27/31)的患眼视力稳定。未出现术后低眼压、视网膜脱离、脉络膜上腔爆发性出血或眼内感染等并发症。结论ECP能有效降低玻璃体切除术后青光眼的眼压,维持视功能,无严重并发症。Objective To evaluate the efficacy of endoscopic cyclophotocoagulation(ECP)in the treatment of glaucoma after vitrectomy.Methods Clinical data of 31 eyes of 30 cases with refractory glaucoma after vitrectomy who received ECP from May 2015 to Dec.2017 in Shanxi Eye Hospital were analyzed retrospectively.Patients were grouped as<180°group with 12 eyes,180°-270°group with 5 eyes,and>270°group with 14 eyes based on the range of ECP.The IOP after surgery,visual acuity at last follow-up and the relationship between different photocoagulation range and postoperative intraocular pressure drop were observed.Results At every time points after surgery,the IOP significantly decreased(F=26.82,P<0.05).The greater the range of photocoagulation,the more effective it was by lowering intraocular pressure.Both of the above were related positively to each other.After surgery,the IOP without anti-glaucoma drugs was normal in 22 cases(70.97%)and abnormal in 7 cases(22.58%)with the application of anti-glaucoma eyedrops.There was no significant difference of visual acuity preoperatively or at the last follow-up(t=-1.18,P>0.05).During the follow-up time,the visual acuity of 27 cases(87.10%)were maintained.No postoperative complications such as hypotonia,retinal detachment,suprachoroidal hemorrhage or endophthalmitis occurred.Conclusion ECP effectively reduces IOP of refractory glaucoma after vitrectomy and maintains visual acuity with no serious complications.

关 键 词：内窥镜检查 青光眼 玻璃体切除术 光凝固术 睫状体 效果 

分 类 号：R779.6[医药卫生—眼科]