超声睫状体成形术治疗青光眼术后眼压失控的疗效评估  

Clinical efficacy of ultrasound cycloplasty in the treatment of uncontrolled intraocular pressure after glaucoma surgery

作　　者：崔晴晴 祁颖[1] 黄雪桃 昝晓宁 姚仁杰 张文静[1] 刘超凡 Cui Qingqing;Qi Ying;Huang Xuetao;Zan Xiaoning;Yao Renjie;Zhang Wenjing;Liu Chaofan(Department of Ophthalmology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院眼科,450052

出　　处：《中华实验眼科杂志》2021年第10期874-879,共6页Chinese Journal Of Experimental Ophthalmology

基　　金：国家自然科学基金面上项目(81970785)。

摘　　要：目的观察超声睫状体成形术(UCP)治疗青光眼术后眼压失控的临床疗效。方法采用系列病例观察研究方法,连续纳入2018年7月至2019年10月于郑州大学第一附属医院接受UCP治疗的青光眼术后眼压失控患者28例28眼,患者在可耐受最大剂量用药情况下眼压仍≥21 mmHg(1 mmHg=0.133 kPa)。根据术前眼压和视力,将患者分为8扇区组17眼和10扇区组11眼。记录UCP手术持续时间,术前和术后1 d、1周、2周、1个月、3个月眼压、最佳矫正视力(BCVA),术前和术后3个月降眼压药物使用种类、眼部疼痛分级、角膜内皮细胞计数,以及术中和术后不良反应。结果UCP治疗时间为3~7 min,平均(4.30±1.26)min。术后1 d、1周、2周、1个月、3个月眼压分别为(32.96±10.49)、(25.89±7.25)、(24.50±6.23)、(24.07±6.59)和(24.32±6.52)mmHg,明显低于术前的(45.82±8.81)mmHg,差异均有统计学意义(均P<0.05)。8扇区组和10扇区组眼压总体比较差异无统计学意义(F组别=1.271,P=0.270),2个组手术前后眼压总体比较差异有统计学意义(F时间=54.388,P<0.01),术后各随访时间点眼压均低于术前,差异均有统计学意义(均P<0.05)。手术前后BCVA总体比较差异无统计学意义(F=2.562,P=0.075)。8扇区组和10扇区组BCVA总体比较差异有统计学意义(F组别=12.602,P=0.001),2个组手术前后BCVA总体比较差异无统计学意义(F时间=1.701,P=0.139),其中各时间点8扇区组BCVA均好于10扇区组,差异均有统计学意义(均P<0.05)。术前8扇区组和10扇区组使用降眼压药物种类分别为3(2,3)种和3(2,4)种,术后3个月使用降眼压药物种类为0(0,1)种和0(0,0)种。术后3个月术眼疼痛等级评分为1(0,1)分,明显低于术前的2(2,2)分,差异有统计学意义(Z=-4.824,P<0.05);8扇区组和10扇区组术后3个月疼痛等级评分均低于术前,差异均有统计学意义(Z=-3.739、-3.127,均P<0.05)。术前角膜内皮细胞计数为(1967.15±186.06)个/mm^(2),术后3个月降至(1Objective To observe the clinical efficacy of ultrasound cycloplasty(UCP)in the treatment of uncontrolled intraocular pressure(IOP)after glaucoma surgery.Methods An observational case series study was carried out.Twenty-eight consecutive patients(28 eyes)with uncontrolled IOP after glaucoma surgery who received UCP treatment in The First Affiliated Hospital of Zhengzhou University from July 2018 to October 2019 were enrolled.The IOP of these patients was≥21 mmHg(1 mmHg=0.133 kPa)under the maximum tolerated dose.According to preoperative IOP and visual acuity,the patients were divided into 8-sector group(17 eyes)and 10-sector group(11 eyes).The duration of UCP operation,preoperative and postoperative 1-day,1-week,2-week,1-month and 3-month IOP and BCVA,the types of drugs for lowering IOP preoperatively and postoperatively,preoperative and postoperative 3-month ocular pain grading and corneal endothelial cell counts,and adverse reactions during the operation and after surgery were recorded.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of The First Affiliated Hospital of Zhengzhou University(No.2020-KY-154).Written informed consent was obtained from each subject prior to any medical examination.Results The duration of UCP operation was 3 to 7 minutes,with an average of(4.30±1.26)minutes.The IOP at 1 day,1 week,2 weeks,1 month and 3 months after operation was(32.96±10.49),(25.89±7.25),(24.50±6.23),(24.07±6.59),(24.32±6.52)mmHg,respectively,which were significantly lower than(45.82±8.81)mmHg before operation(all at P<0.05).There was no significant difference in IOP between the 8-sector group and 10-sector group(Fgroup=1.271,P=0.270),but there was a significant difference in IOP between the two groups before and after operation(Ftime=54.388,P<0.01),and the postoperative IOP at various time points in the two groups were lower than the preoperative IOP,showing statistical significances(all at P<0.05).There was no significant difference in BCVA before and

关 键 词：超声睫状体成形术 眼压 青光眼术后眼压失控 

分 类 号：R779.6[医药卫生—眼科]