半导体激光经巩膜睫状体光凝术治疗难治性青光眼的疗效观察

Clinical Efficiency of Transscleral Cyclophotocoagu Lation (TSCPC) for Refractory Glaucoma

目的:探讨半导体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:回顾性分析2009-06～2009-12收治的46例46眼难治性青光眼患者,采用TSCPC治疗,观察并记录视力、眼压、眼部自觉症状及并发症。随访时间约3月,分别记录术后1 d,1周,1月,3月眼部情况。结果:术后随访3月以上,术前平均眼压55.86±11.46 mmHg,术后最后随访平均眼压为17.13±7.06 mmHg。经统计学检验,术前与术后眼压相比,差别具有统计学意义(P<0.05);术后视力:33例视力无变化,8例视力提高,5例视力下降;术后患者眼痛消失或缓解;并发症较少,程度较轻,主要有球结膜水肿、葡萄膜炎、角膜水肿、前房出血等。结论:TSCPC能够有效控制难治性青光眼患者的眼压,减轻患者痛苦,挽留患者眼球,成为晚期难治性青光眼治疗的首选方法。

Objective：To evaluate clinical efficiency of transscleral cyclophotocoagu lation（TSCPC） for refractory glaucoma.Methods：Retrospective analysis was made in 46 patients（46 eyes） of refractory glaucoma treated by TSCPC within 2009-06 to 2009-09.Visual acuity,intraocular pressure（IOP）,ocular symptoms and complications were observed after TSCPC.Patients were followed up for 3 months and examed at 1d,1wk,1 and 3 mo.Results：Patients were followed up for 3 months.The mean preoperative IOP was 55.86±11.46 mmHg which was significantly different from the final follow-up mean IOP 17.13±7.06 mmHg（P0.05）.Postoperative visual acuity remained unchanged in 33 eyes;improved in 8 eyes and decreased in 5 eyes.The pain sense disappeared or remarkably relieved after cyclocryotherapy.The main complications of bulbar conjunctiva edema,uveitis and hyphema occurred rarely and mildly.Conclusions：TSCPC can effectively control intraocular pressure,retrieve eyeballs and elliavate pains of patients of efractory glaucoma.TSCPC is blieved to be the optimizal treatment policy for eyes with refractory glaucoma.