晶状体玻璃体切割术联合内窥镜下睫状体光凝术治疗外伤性晶状体脱位继发性青光眼的疗效和安全性  

Efficacy and safety of lensectomy and vitrectomy combined with endoscopic cyclophotocoagulation in the treatment of glaucoma secondary to traumatic lens luxation

作　　者：康焕君 辛柳青 贾金辰 刘芳 KANG Huanjun;XIN Liuqing;JIA Jinchen;LIU Fang(Department of Ocular Trauma,Hebei Eye Hospital,Xingtai 054001,Hebei Province,China)

机构地区：[1]河北省眼科医院眼外伤科,河北省邢台市054001

出　　处：《眼科新进展》2023年第2期147-150,共4页Recent Advances in Ophthalmology

摘　　要：目的探讨晶状体玻璃体切割术联合内窥镜下睫状体光凝术(ECP)治疗外伤性晶状体脱位继发性青光眼的疗效和安全性。方法选取2017年3月至2020年7月河北省眼科医院眼外伤科收治的外伤性晶状体脱位继发性青光眼患者55例(55眼)作为研究对象。取其中35例(35眼)患者作为观察组,行晶状体玻璃体切割术联合ECP+Ⅰ期人工晶状体悬吊术进行治疗;另20例(20眼)作为对照组,行晶状体玻璃体切割+人工晶状体悬吊联合其他抗青光眼手术。对照组患者中行晶状体玻璃体切割+人工晶状体悬吊联合小梁切除术10例,联合引流物植入术7例,联合睫状体分离术3例。术后1个月根据眼压降低情况评估手术效果,分析患者手术疗效、眼压、视力和并发症发生情况。结果术后1个月,观察组完全成功24眼,部分成功8眼,失败3眼,手术成功率为91.43%;对照组完全成功8眼,部分成功6眼,失败6眼,手术成功率为70.00%。观察组手术成功率明显高于对照组(P<0.05)。观察组患眼术后1周、2周、1个月、3个月、6个月、9个月、12个月时眼压均较术前明显降低,差异均有统计学意义(均为P<0.05)。术后1个月,观察组视力进步32眼(91.43%),无变化3眼(8.57%);术后观察组有26眼(74.29%)视力>0.1。观察组患眼视力明显高于术前水平,差异有统计学意义(P<0.05)。观察组与对照组总体并发症发生率分别为0%、50%,差异有统计学意义(P<0.001)。结论晶状体玻璃体切割术联合ECP+Ⅰ期人工晶状体悬吊术操作较为简单,在治疗外伤性晶状体脱位继发性青光眼方面疗效显著,可明显改善患者眼压与视力,对周围组织损伤较小,安全性较高。Objective To investigate the efficacy and safety of lensectomy and vitrectomy combined with endoscopic cyclophotocoagulation(ECP)in treating glaucoma secondary to traumatic lens luxation.Methods A total of 55 patients(55 eyes)with glaucoma secondary to traumatic lens luxation who were admitted to the Department of Ocular Trauma,Hebei Eye Hospital from March 2017 to July 2020 were selected as the research subjects.Among them,35 patients(35 eyes)who underwent lensectomy and vitrectomy combined with ECP and phase I intraocular lens suspension were included in the observation group,and 20 patients(20 eyes)who underwent lensectomy and vitrectomy combined with intraocular lens suspension and other anti-glaucoma surgery were selected as the control group.In the control group,10 patients underwent lensectomy and vitrectomy combined with intraocular lens suspension and trabeculectomy,7 patients underwent lensectomy and vitrectomy combined with intraocular lens suspension and drainage implantation,and 3 patients underwent lensectomy and vitrectomy combined with intraocular lens suspension and cyclodialysis.The surgical effect,intraocular pressure,visual acuity and complications were analyzed 1 month after the operation based on the decrease in intraocular pressure.Results One month after the operation,the treatments were completely successful for 24 eyes,partially successful for 8 eyes and failed for 3 eyes in the observation group,with a success rate of 91.43%.In the control group,the treatments were completely successful for 8 eyes,partially successful for 6 eyes and failed for 6 eyes,with a success rate of 70.00%.The success rate of operation in the observation group was significantly higher than that in the control group(P<0.05).The intraocular pressure of affected eyes of the observation group at 1 week,2 weeks,1 month,3 months,6 months,9 months and 12 months after the operation was significantly lower than that before the operation,and the differences were statistically significant(all P<0.05).One month after the ope

关 键 词：外伤性晶状体脱位 晶状体玻璃体切割术 睫状体光凝术 人工晶状体植入术 

分 类 号：R775.3[医药卫生—眼科]