新生血管性青光眼手术治疗分析

Effects of different operation on neovascular glaucoma

目的比较不同手术方法治疗新生血管性青光眼(NVC)的疗效。方法对30例30只眼NVG的不同手术方式进行回顾性分析,其中行单纯睫状体冷凝术10例,周边视网膜冷凝联合睫状体冷凝术13例,小梁切除+睫状体冷凝+次全视网膜冷凝术7例。比较患者手术前后主观眼痛症状、眼压及视力变化情况。随访10-28个月。结果患者出院时的平均眼压:A组为(28.08±5.11)mmHg,B组为(20.60±6.28)mmHg,C组为(19.43±7.07)mmHg。随访期间,术后A组4例眼压正常,手术成功率40%,B组10例眼压正常,手术成功率76.9%,C组4例眼压正常,手术成功率57.1%。结论对于不同病情的NVG患者,可以采用不同的手术方式进行治疗。传统睫状体冷凝术在缓解疼痛及降低眼压方面作用明显,但疗效欠稳定,术后并发症多。小梁切除+睫状体冷凝+次全视网膜冷凝术手术要求较高,容易引起新生血管出血。对于晚期病例合并屈光间质浑浊的新生血管性青光眼,选择次全视网膜冷凝联合睫状体冷凝治疗是一种较理想的方法。

Objective To evaluate the clinical effects of different surgical management on neovascular glaucoma （NVG）. Methods 30 eyes in 30 cases with neovascular glaucoma received different surgical manage- ments were analyzed retrospectively. All eases were dived into three groups： Group A： 10 eyes treatd with cyclo- cryotherapy, Group B： 13 eyes treated with the retina cryoautery combined with ciliary body cryoantery, and Group C ： 7 eyes trated with combination of trabeculectomy and cryothe rapy of peripheral retina and ciliary. Pre and post- operative intraocular pressures （lOPs） were comparatively observed in all cases. The changes in visual acuity were evaluated. Results The intraocular pressure （IOP） were controlled to （ 28.08 ± 5.11 ） mmHg in 4 cases, （20. 60 ± 6.28） mmHg in 10 eyes and （ 19.43 ± 7.07） mmHg in 4 cases, with the surgery successful rate 40%, 76.9% and 57.1% in group A, B and C, respectively. Conclusions Various surgery techniques for neovascular glaucoma should be chosen depending on different condition.