超声睫状体成形术治疗难治性青光眼的疗效及安全性  

Efficacy and safety of ultrasound cycloplasty in the treatment of refractory glaucoma

作　　者：苗壮 兰长骏 徐正东[1] 杨月 周梦兰 Miao Zhuang;Lan Changjun;Xu Zhengdong;Yang Yue;Zhou Menglan(Aier Eye Hospital(East of Chengdu),Chengdu 610056,Sichuan Province,China;Department of Ophthalmology,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan Province,China)

机构地区：[1]成都东区爱尔眼科医院,四川省成都市610056 [2]川北医学院附属医院眼科,四川省南充市637000

出　　处：《国际眼科杂志》2024年第6期985-989,共5页International Eye Science

基　　金：成都市医学科研课题(No.2022213)。

摘　　要：目的:探讨超声睫状体成形术治疗难治性青光眼的安全性及临床有效性。方法:前瞻性研究。收集2021-06/2022-10在我院就诊的难治性青光眼患者17例17眼,均行超声睫状体成形术治疗。随访6 mo,记录患者眼压、疼痛等级评分、降眼压药物使用、手术成功率以及并发症发生情况。结果:术后1 d(32.54±13.21 mmHg)、1 wk(22.38±11.98 mmHg)、1 mo(22.63±10.78 mmHg)、3 mo(26.05±9.17 mmHg)、6 mo(23.73±9.60 mmHg),均较术前眼压(51.98±7.80 mmHg)下降(均P<0.01);术后各时间节点眼压降低率依次为36.25%、57.10%、56.35%、49.16%、54.09%。术后疼痛等级评分较术前下降(P<0.01)。术后降眼压药物使用数量较术前减少(P=0.008)。术后6 mo时完全成功2眼(12%),部分成功11眼(65%),失败4眼(24%)。术后1 d发生前房炎性反应1眼(6%)、异物感2眼(12%)、结膜下出血2眼(12%)、结膜充血6眼(35%),所有症状均在1 wk内自行消失。术后10 d发生脉络膜脱离1眼(6%),经口服醋酸泼尼松片治疗1 mo后恢复。未见前房积血、瞳孔异位、虹膜黏连、黄斑水肿等严重并发症。结论:超声睫状体成形术治疗难治性青光眼可有效降低眼压,减轻患者眼部疼痛症状,并具有良好的安全性。AIM:To evaluate clinical efficacy and safety of ultrasound cycloplasty(UCP)in the treatment of refractory glaucoma.METHODS:From June 2021 to October 2022,a total of 17 patients(17 eyes)with refractory glaucoma were enrolled in this prospective study,and they all underwent UCP.The patients underwent 6 mo followed-up post-treatment,and the intraocular pressure(IOP),pain grade score,IOP lowering drugs,success rate and occurrence of complications were documented.RESULTS:The IOP was significantly decreased from 51.98±7.80 mmHg before UCP to 32.54±13.21 mmHg at 1 d,22.38±11.98 mmHg at 1 wk,22.63±10.78 mmHg at 1 mo,26.05±9.17 mmHg at 3 mo,and 23.73±9.60 mmHg at 6 mo postoperatively(all P<0.01).The percentage of IOP reduction after treatment was 36.25%,57.10%,56.35%,49.16%and 54.09%at 1 d,1 wk,1,3,and 6 mo,respectively.The pain grade scores were decreased(P<0.01).There was a statistically significant reduction in the use of IOP lowering medications(P=0.008).At 6 mo postoperatively,2 eyes(12%)were complete success,11 eyes(65%)were qualified success,and 4 eyes(24%)were failure.The main complication observed was anterior chamber inflammation in 1 eye(6%),foreign body sensation in 2 eyes(12%),subconjunctival hemorrhage in 2 eyes(12%),and conjunctival congestion in 6 eyes(35%).All symptoms spontaneously resolved within 1 wk without requiring any specific treatment.One case of choroidal detachment(6%)occurred on 10 d postoperatively,but recovered after orally treated by prednisone acetate for 1 mo.No other serious complications,such as hyphema,corectopia,synechia or macular edema were reported.CONCLUSION:UCP is safe and efficacious in treating refractory glaucoma,reducing IOP and alleviating ocular pain symptoms,while maintaining a favorable safety profile.

关 键 词：超声睫状体成形术 高强度聚焦超声 难治性青光眼 眼压 

分 类 号：R779.6[医药卫生—眼科]