二极管激光经巩膜睫状体光凝治疗新生血管性青光眼

Transscleral diode laser cyclophotocoagulation for treatment of neovascular glaucoma

目的评价二极管激光经巩膜睫状体光凝术(transscleral diode laser cyclophotocoagulation,TDLC)治疗新生血管性青光眼的临床效果。方法选择眼压高于21mmHg(1kPa=7.5mmHg)、常规用药眼压不能控制、视力低于0.02,或滤过性手术失败且拒绝再次行滤过手术的新生血管性青光眼患者21例(21眼),采用美国IRIS公司生产的Ocu-lightSLx型二极管激光治疗仪行TDLC,采用Goldmann压平式眼压计测量术前、术后眼压,记录术后1d、1周、1个月、3个月的眼压变化。结果术前眼压平均为(44.86±5.11)mmHg,术后1d、1周、1个月、3个月平均眼压为(25.67±4.00)mmHg、(20.67±3.88)mmHg、(18.14±4.70)mmHg、(16.95±4.09)mmHg,均较术前眼压明显降低,差异显著(P<0.001)。且术后并发症少,无一例出现低眼压及交感性眼炎。结论TDLC是一种有效治疗新生血管性青光眼的方法,术后眼压平稳、并发症少且能保护患者的视功能,是一种安全、高效、重复性好的治疗方法。

Objective To evaluate the clinical effect of transscleral diode laser cyclophotocoagulation （TDLC） in the treatment of neovaseular glaucoma. Methods Twenty-one eyes of 21 patients with neovascular glaucoma, whose intraocular pressure （IOP） was more than 21 mmHg（1 kPa =7.5 mmHg） and visual acuity lower than 0.02, were treated with TDLC. Some of them were suffering from uncontrolled glaucoma by routine medication. Some patients who had undergone previous filtering operation refused to the operation again. The equipment was made by IRIS Company,USA. IOP was measured with Goldman applanation tonometer pre-operatively and at 1 day, 1 week, 1 month, 3 months post-operatively. Results The mean preoperative IOP was （44.86±5.11 ） mmHg; The mean IOP at 1 day, l week, 1 month, 3 months post-operatively were （ 25.67 ± 4.00 ） mmHg, （ 20.67 ± 3.88）mmHg, （18.14±4.70 ） mmHg and （ 16.95±4.09） mmHg respectively, which was significantly lower than that of pre-operation （ P 〈 0.01 ）. No patient got intraocular hypotension and sympathetic ophthalmia. Conclusion TDLC is an effective procedure for the treatment of neovaseular glaucoma. It is a safe, effective and better-reproductive treatment to protect the patient＇ s visual function.