新生血管性青光眼联合手术治疗的临床观察

Combined surgery for neovascular glaucoma

目的探讨联合手术治疗新生血管性青光眼（NVG）的疗效。方法对53例（53眼）NVG根据病情分3组采用联合手术的治疗方法。（1）A组23眼，先应用多波长氪激光行超广泛视网膜光凝术，光凝术后1～2周进行小梁切除术，术中应用丝裂霉素C（0．4mg／mL）棉片放置巩膜瓣下3～5rain。（2）B组17眼，先应用氪绿激光对虹膜面及房角新生血管直接光凝，2周后行小梁切除术，术中应用丝裂霉素c。（3）C组13眼，选用睫状体冷凝联合全周边视网膜冷凝术。结果6个月随访时：（1）A组成功率78．3％；平均眼压为（17．35±5．23）mmHg。（2）B组成功率为82．4％；平均眼压为（15．94±4．17）mmHg。（3）c组成功率为76．9％；平均眼压为（17．31±5．00）mmHg。结论针对不同程度的NVG要采用不同的治疗方法，并根据病情的发展随时调整治疗方案。

Objective To observe the clinical outcomes ot combined surgical managements for neovascular glaucoma （NVG）. Methods 53 eyes of 53 cases of neovascular glaucoma were divided into three groups. 23 eyes of 23 cases in group A had undergone trabeculectomy with mitomycin C （MMC） 1 - 2 weeks after panretinal photocoagulation （PRP） previously. Cotton tampon with O. 4 mg/mL MMC had been put under the scleral valve for 3-5 min. Group B： trabeculecomy with mitomycin C （MMC） was performed in 17 eyes of 17 cases 2 weeks after photocoagulation on iris neovascular （NV） previously. Group C ： Combination of cryotherapy of cliliary and peripheral retina was performed in 13 eyes of 13 cases. Results During 6 months of follow-up, the intraocular pressure （IOP） was controlled to （17. 35 ± 5.23 ） mmHg in group A and （ 15.94 ±4. 17） mmHg in group B, the surgery successful rate was 78.3% and 82.4% respectively. The IOP was controlled to （17.31 ±5.00） mmHg in group C and the surgery successful rate was 76. 9%. Conclusion The combined surgical management were obviously effective for NVG, and various surgery techniques should be chosen depending on the different eye conditions.