经巩膜睫状体光凝术治疗难治性青光眼预后及影响因素  

Prognosis and influencing factors of transscleral cyclophotocoagulation for the treatment of refractory glaucoma

作　　者：易允娣 刘贺婷[1] 鲍宁[1] 陶黎明[1] Yi Yundi;Liu Heting;Bao Ning;Tao Liming(Department of Ophthalmology,the Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China)

机构地区：[1]安徽医科大学第二附属医院眼科,合肥230601

出　　处：《临床眼科杂志》2023年第3期252-256,共5页Journal of Clinical Ophthalmology

基　　金：2020安徽省重点研究与开发计划项目(202004j07020029)。

摘　　要：目的分析经巩膜睫状体光凝术治疗难治性青光眼短期预后情况以及影响因素。方法回顾性病例研究。收集2018年1月至2021年12月安徽医科大学第二附属医院的难治性青光眼90例(90只眼)。分别收集术前及术后1 d、1周、1个月、3个月、6个月患者检查情况,记录视力、眼压、降眼压药物和任何并发症,并根据患者资料对影响经巩膜睫状体光凝术治疗难治性青光眼早期预后的相关因素进行初步筛选,采用多因素Logistic回归模型分析其影响因素。结果患者术前、术后1 d、1周、1个月、3个月、6个月平均眼压分别为(43.9±12.0)、(25.57±8.5)、(23.5±7.5)、(22.3±8.1)、(23.2±8.4)、(24.2±9.1)mmHg;重复测量方差分析结果显示不同时间点测量的眼压与术前相比差异均有统计学意义(F=76.031,均P<0.01)。随着时间延长,患者手术成功率逐渐减少,研究中术后6个月总体累积成功概率为67.7%。多因素回归分析结果显示:术前眼压和术后再次治疗是经巩膜睫状体光凝术治疗难治性青光眼短期预后独立保护因素(P<0.05);性别是其非独立影响因素(均P>0.05)。结论经巩膜睫状体光凝术是治疗难治性青光眼有效的手术方式,不良反应较少,术前眼压和术后再次治疗影响患者手术成功率。Objective To analyze the short-term prognosis and influencing factors of transscleral cyclophotocoagulation for the treatment of refractory glaucoma.Methods A retrospective analysis was performed based on 90 cases(90 eyes)who were diagnosed with refractory glaucoma at the department of ophthalmology in the second affiliated Hospital of Anhui Medical University from January 2018 to December 2021.The patients were examined before the operation and at 1 day,1 week,1 month,3 months and 6 months after the operation.The visual acuity,intraocular pressure(IOP),IOP lowering drugs and any complications were recorded.The factors affecting the early prognosis of transscleral cyclophotocoagulation for refractory glaucoma were screened and analyzed by multivariate logistic regression model.Results The mean IOP before the operation,at 1 day,1 week,1 month,3 months and 6 months after the operation were(43.9±12.0),(25.57±8.5),(22.3±8.1),(23.2±8.4 and 24.2±9.1)mmHg,respectively.Repeated measurements showed that the IOP measured at different time points was significantly different from that before the operation(P<0.05).With the extension of time,the success rate of surgery decreased gradually,and the overall cumulative probability of success at 6 months after the operation was 67.7%.The results of multivariate regression analysis showed that preoperative intraocular pressure and postoperative retreatment were independent protective factors for short-term prognosis of refractory glaucoma treated with transscleral cyclophotocoagulation(P<0.05).Sex was an non-independent influencing factors(all P>0.05).Conclusions Transscleral cyclophotocoagulation is an effective method for the treatment of refractory glaucoma with few adverse reactions.Preoperative intraocular pressure and postoperative retreatment affect the success rate of surgery.

关 键 词：青光眼 经巩膜睫状体光凝术 眼压 

分 类 号：R779.6[医药卫生—眼科]