二极管激光经巩膜睫状体光凝术治疗难治性青光眼

Transscleral diode laser cyclophotocoagulation for refractory glaucoma

目的观察二极管激光经巩膜睫状体光凝术治疗难治性青光眼的临床疗效。方法回顾性分析北京同仁医院2007年9月至2008年8月107例(110眼)难治性晚期青光眼患者临床资料,均行二极管睫状体光凝,分析术后眼压、疼痛感、视力、并发症等情况。结果术后第1天平均眼压(15.90±12.30)mmHg(1kPa=7.5mmHg),术后1周平均眼压(14.70±5.21)mmHg,术后1个月平均眼压(14.02±9.50)mmHg,术后3个月平均眼压(14.51±11.30)mmHg,术前与术后第1天、1周、1个月及3个月眼压差异均有统计学意义(均为P<0.01)。术后89眼(80.9%)视力不变,17眼(15.5%)视力下降,4眼(3.6%)视力提高。83.6%的患者眼痛症状明显缓解或消失。术后发生前房渗出12眼(10.9%),前房积血6眼(5.4%),玻璃体积血2眼(1.8%),巩膜溶解2眼(1.8%),巩膜穿孔1眼(0.9%)。结论二极管激光经巩膜睫状体光凝术是治疗难治性晚期青光眼的有效方法,能显著降低眼压,减少患者痛苦,并发症少,可重复治疗。

Objective To evaluate the therapeutic effects of transscleral diode laser cyclophotocoagulation for refractory glaucoma.Methods Retrospective analysis was taken in 107 patients（110 eyes） with refractory glaucoma,who were treated with diode laser cyclophotocoagulation from September 2007 to August 2008 in Beijing Tongren hospital.Intraocular pressure（IOP）,easement of pain,visual acuity and complications were analyzed.Results The average IOP were（15.90±12.30）mmHg（1 kPa=7.5 mmHg）,（14.70±5.21）mmHg,（14.02±9.50）mmHg and （14.51±11.30）mmHg at postoperative 1 day,1 week,1 month and 3 months.The difference in IOP at preoperation was significant compared with those at postoperative 1 day,1 week,1 month and 3 months（all P〈0.01）.Visual acuity remained in 89 eyes（80.9%）,decreased in 17 eyes（15.5%） and improved in 4 eyes（3.6%） postoperatively.Ophthalmalgia significantly relieved or disappeared in some patients（83.6%）.Anterior chamber exudation was in 12 eyes（10.9%）,hyphema in 6 eyes（5.4%）,vitreous hemorrhage in 2 eyes（1.8%）,sclera dissolved in 2 eyes（1.8%） and scleral perforation in 1 eye（0.9%）.Conclusions Transscleral diode laser cyclophotocoagulation is an effective and simple treatment for patients with refractory glaucoma.It can decrease IOP evidently,relieve pain from patients,be with few complications and take treatment again.