难治性青光眼半导体激光经巩膜睫状体光凝术

Transscleral diode laser cyclophotocoagulation for the treatment of refractory glaucoma

目的 评价半导体激光经巩膜睫状体光凝术治疗难治性青光眼的效果和安全性。方法 68例 (69眼 )接受治疗 ,术后随访 6～ 17月。分析末次治疗后第 6月的眼压、视力和眼部症状。结果 无光感组 (3 6眼 ) :光凝术前眼压 (61.16± 12 .44 )mmHg(1mmHg =0 .13 3kPa) ,末次光凝术后第 6月后 3 3眼眼压 (2 9.67± 6.79)mmHg。 3眼眼球萎缩 ,12眼需 2次或多次治疗。光感及光感以上组 (3 3眼 ) :光凝术前眼压 (5 1.72± 13 .85 )mmHg ,末次光凝术后第 6月眼压 (2 1.42± 8.2 2 )mmHg。其中 11眼需要 2次或 3次光凝术 ,4眼 3次光凝术后眼压仍高于 2 1mmHg。结论 半导体激光经巩膜睫状体光凝术是一种简单、安全、有效的治疗难治性青光眼的方法 ,但常需要重复治疗。

Objective To evaluate the efficiency and safety of transscleral diode laser cyclophotocoagulation for the treatment of refractory glaucoma retrospectively.Methods 68 cases (69 eyes) of refractory glaucoma were treated and followed up for 6-17 months (averaged 11.55±3.36 months).The intraocular pressure (IOP), visual acuity and ocular symptoms after 6 months of last treatment were analyzed.Results No light perception eyes(36 eyes):pretreatment IOP was 40-80 mmHg (61.16±12.24mmHg) and was reduced to 12-39 mmHg (29.67±6.79 mmHg) after 6 months of the last treatment in 33 eyes, 12 eyes needed 2 or more times of treatment and phisis appeared in 3 eyes. Light perception or better visual acuity eyes (33 eyes): pretreatment lOP was 28-81mmHg (51.72± 13.85mmHg) and was reduced to 13-45mmHg (21.42±8.22mmHg),11 eyes needed 2 or more times of treatment and IOP was higher than 21 mmHg in 4 eyes after 3 times of treatment.Conclusion Transscleral diode laser cyclophotocoagulation is a simple,safe and effective method for the treatment of refractory glaucoma,however,repeated treatments are often necessary.