半导体激光治疗重症青光眼——睫状体光凝和睫状体冷冻的对比研究

Diode laser transscleral cyclophotocoagulation for severe glaucoma

６０例（６０只眼）重症青光眼患者，随机分成半导体激光经巩膜睫状体光凝组和睫状体冷冻组。半导体激光功率１．５～２．０Ｗ、脉冲时间２ｓ、治疗范围２７０°，发射１２～２０个激光点。所有病例均完成３个月的随访观察，结果与冷冻组比较，光凝组治疗成功率为７３．３％，疼痛解除率为９６．７％，Ｐ＞０．０５；光凝组治疗后１天及１周的眼压分别为２２．１０±９．３４ｍｍＨｇ和１８．１３±６．４０ｍｍＨｇ，Ｐ＜０．０１；末次随访时光凝组眼压２０．５４±７．９６ｍｍＨｇ，Ｐ＞０．０５。光凝组早期并发症少，Ｐ＜０．０１。半导体激光经巩膜睫状体光凝与传统的睫状体冷冻比较，具有简便、安全、降压快、副作用小、疗效可靠等优点，是治疗难治性青光眼的有效手段之一。

eyes of 60 patients with severe glaucoma were divided at random into two groups:one treated with diode laser transscleral cyclophotocoagulation(TSCPC),and the other with cyclocryotherapy.Laser energy was delivered to the eye through a fiber optic G probe(12 to 20 spots over 270 degrees,1.75w energy applied for 2.0 sec).Follow up observations were made for all patients for 3 months.In contrast to cyclocryotherapy,success rate in TSCPC group was 73.3%,pain relief rate 96.7%,P>0 05;IOP at one day and at one week after the TSCPC were 22.10±9.34mmHg,18.13±6.40mmHg respectively,P<0 01.At the last observation,IOP was 20.54±7.96mmHg,P>0 05.The incidence of early complication in TSCPC group was low,P<0 01.Our result showed that diode laser transscleral cyclophotocoagulation for severe glaucoma had such advantages as simplicity,convenience,safety and reliability,and also could reduce IOP quickly,so it was an effective therapeutic method of curing refractory glaucoma.