半导体激光经巩膜睫状体光凝治疗新生血管性青光眼

Contact Diode Laser Trans-scleral Cyclophotocoagulation Treatment for Neovascular Glaucoma

目的 评价半导体激光经巩膜睫状体光凝治疗新生血管性青光眼的近期和远期疗效。方法 对 89例 91眼新生血管性青光眼施行接触式半导体激光经巩膜睫状体光凝 ,半导体激光波长为 810nm ,将激光束聚焦于睫状体冠部 ,除内、外直肌时区外 ,均匀分布 2 6～ 34个击射点 ,能量 1 5～ 2 5W ,时间 1 5s。术后随访 2周至 3 5年。结果 以降低眼压 30 %为手术成功标准 ,近期成功率为 92 3% ,疼痛缓解率为 96 5 % ,远期成功率为 83 3% ,疼痛缓解率为95 2 %。少数病例有色素膜炎、前房出血等并发症。结论 半导体激光经巩膜睫状体光凝是治疗新生血管性青光眼有效、安全。

Objective Aimed to evaluate the clinical efficacy of contact diode laser trans scleral cyclophotocoagulation (Tscpc) for treatment of neovascular glaucomas. Methods Ninety one eyes of 89 patients with neovascular glaucomas were treated and followed up from 0 5-38 months (average 14 3 months) after Tscpc. Area: 24-34 spots spreaded 360 degrees (the locations of attachment of medial and lateral rectus were reserved); site: 1 5 mm posterior to limbus; the treatment parameters using the contact Gprobe were: energy 1 5-2 5 W, time 1 000-2 000 ms. Results Successful control of IOP(IOP decreased 30% or more from the baseline) occurred in 92 3% of the treated eyes shortly after the treatment and in 83 3% of the treated eyes at the last follow up. Successful control of painless occurred in 96 5% of the treated patients. Complications included uveitis a hyphyma, etc. Conclusions Contact trans scleral diode laser cyclophotocoagulation is a safe and effective method for the treatment of neovascular glaucoma.