难治性青光眼睫状体光凝疗效观察

Therapeutic effect observation on cyclophotocoagulation for refractory glaucoma

目的：评价激光经巩膜睫状体光凝术（transscleral cyclo-photocoagulation,TSCPC）治疗难治性青光眼的临床疗效。方法：对36眼难治性青光眼采用低能量1.5~2.1W,多点数10~32的TSCPC,术后随访观察并记录眼压,视力,眼部自觉症状以及并发症,随访时间约3mo。结果：术前平均眼压62.89±17.36mmHg,最后随访平均眼压为21.13±7.06mmHg,经配对资料t检验,术前眼压与术后眼压相比,差别具有统计学意义（P〈0.05）。手术有效率83%。指数以上视力10眼中术后6眼视力无变化,4眼视力提高。6眼眼压控制欠佳,行睫状体冷冻手术。术前所有眼痛的患者眼痛均消失或缓解,并发症少,程度轻,主要有色素膜炎,前房出血等,无眼球萎缩发生。结论：TSCPC是难治性青光眼的一种简单安全有效的治疗方法。

·AIM：To evaluate the efficiency of transscleral cyclophotocoagulation（TSCPC）for refractory glaucoma.·METHODS：Retrospective analysis was made in 36 eyes with refractory glaucoma treated by TSCPC with lower energy power（1.5-2.1W）and more laser spots（10-32）.Intraocular pressure（IOP）,visual acuity,ocular symptoms and complications were observed after TSCPC.Patients were followed up for 3 months.·RESULTS：The mean preoperative IOP was 62.89±17.36mmHg which was significantly different from the final follow-up mean IOP,21.13±7.06mmHg（P〈0.05）.The success rate was 83%（30/36）.Postoperative visual acuity remained unchanged in 6 eyes;improved in 4 eyes.The cyclocryotherapy were performed in 6 eyes whose IOP was not controlled.The pain sense disappeared or remarkably relieved.The main complications included mild uveitis and hyphemae.Atrophy of eyeball occurred in no eye.·CONCLUSION：TSCPC is a simple,safe and effective method for eyes with refractory glaucoma.