新生血管性青光眼治疗时机的临床研究

Treatment choice of different stages for neovascular glaucoma

目的:探讨新生血管性青光眼(neovascular glaucoma,NVG)发病不同时期治疗方案的选择。方法:对116例123眼被诊断为NVG患者的病历资料,按照CNV的不同分期进行回顾性总结。结果:NVGⅠ期患者17眼行全视网膜光凝,16眼新生血管消退。Ⅱ期57眼中,17眼行全视网膜光凝,新生血管消退。26眼行全视网膜光凝联合小梁切除术,23眼眼压控制良好。9眼行玻璃体切除+全视网膜光凝联合小梁切除术,8眼眼压控制良好。5眼行青光眼阀植入术联合全视网膜光凝术,眼压控制良好。Ⅲ期49眼中,3眼行青光眼阀植入术联合全视网膜光凝术,2眼眼压控制良好。38眼行周边视网膜冷凝、睫状体冷冻联合小梁切除术,29眼眼压控制良好。3眼行眼球摘除术,5眼行睫状神经剪断术。结论:从NVG分期角度出发,应根据患者不同病情制订个体化的治疗方案。

·AIM： To investigate the treatment choice of different stages for neovascular glaucoma（NVG）.· METHODS： The case information of 123 eyes of 116 NVG patients were analyzed and summarized retrospectively, according to different stages of NVG. · RESULTS： At the first stage, of the 17 eyes performed panretinal photocoagulation, the new vessels of 16 eyes were disappeared. At the second stage of 57 eyes, the new vessels of 17 eyes disappeared after panretinal photocoagulation. Of 26 eyes performed panretinal photocoagulation and trabeculectomy, the IOP of 23 eyes were fully controlled. Of 9 eyes performed vitrectomy and panretinal photocoagulation and trabeculectomy, the IOP of 8 eyes were fully controlled. All 5 eyes performed glaucoma drainage implant placement appeared fully controlled. At the third stage of 49 eyes, of 3 eyes performed glaucoma drainage implant placement, the IOP of 2 eyes were controlled. Of 38 eyes performed panperipheral retinal cryotheraphy and cyclocryotherapy and trabeculectomy, the IOP of 29 eyes were controlled. · CONCLUSION ： From the view of NVG different stages, the individual treatment should be performed according to various clinical characteristic.