半导体激光经巩膜睫状体光凝术治疗晚期外伤性青光眼

Transscleral diode laser cyclophotocoagulation for the treatment of advanced stage traumatic glaucoma

目的探讨半导体激光睫状体光凝术治疗晚期外伤性青光眼的疗效。方法67例（67只眼）接受治疗，随防时间≥6月，分析治疗后第6月的眼压、视力和眼部症状。结果视力无光感或光感的眼（I组），光凝术后眼部疼痛消失为成功。Ⅰ组37只眼：1次光凝治疗后21只眼（56．76％）成功，其余16只眼（43．24％）需要经2次或2次以上光凝治疗；17只光感的眼中有9只眼变为无光感，4眼眼球萎缩。视力为手动或优于手动的眼（Ⅱ组），眼压在5～21mmHg者为成功。Ⅱ组30只眼：1次光凝治疗16只眼，2次或2次以上治疗14只眼；共有22只眼（66．67％）成功，2只眼眼球萎缩，5只眼视力丧失。两组患眼1次光凝治疗，新生血管型与其他类型的外伤性青光眼的成功率差异均无统计学意义。结论半导体激光经巩膜睫状体光凝术是一种简单、安全、有效的治疗晚期外伤性青光眼的方法，但常需要重复治疗。因术后存在着视力丧失和眼球萎缩的可能，对有视力的眼应慎重使用。

Objective To evaluate the efficiency of transscleral diode laser cyclophotocoagulation for the treatment of advanced stage traumatic glaucoma.Methods 67 eyes （67patients）with advanced stage traumatic glaucoma were treated and followed up at least for 6 months.The intraocular pressure, acuity of vision, and eye symptoms in the 6th month after the latest treatments were analyzed.Results Light perception or no light perception eyes （I group ）, which successful control was defined as the disappear of the ocular pain with or without antiglaucoma medications after treatments.37 eyes in group Ⅰ ： 21 eyes （56.76%）were successfully controlled with 1 treatment and the rest 16 eyes （43.24%）needed 2 or more than 2 treatments.9 eyes out of 17 light perception eyes became no light perception.4 eyes became hypotony.Hand movement or better visual acuity eyes （ Ⅱ group） ,which successful control was defined as intraocular pressure between 5- 21mmHg with or without antiglaucoma medications after treatments.30 eyes in group Ⅱ ： 16 eyes received 1 treatment and 14 eyes received 2 or more than 2 treatments.There are 22 eyes（ 66.67% ）succeed in total.2 eyes became hypotony and 5 eyes became no light perception.Neovascular and other types of traumatic glaucoma were no statistically significant difference in successful control for every group.Conclusions Transscleral diode laser cyclophotocoagulation is a simple, safe and effective method for the treatment of advanced stage traumatic glaucoma, however, repeated treatments are often necessary.As visual loss and hypotony exist after treatment, eyes with visual acuity should be more cautious.