532nm激光全视网膜光凝联合睫状体光凝治疗新生血管性青光眼疗效观察

The effect observation of 532 nm laser panretinal photocoagulation combined with cyclophotocoagulation in the treatment of neovascular glaucoma

目的观察532 nm激光全视网膜光凝联合睫状体光凝治疗新生血管性青光眼（neovascular glaucoma,NVG）的疗效。方法对16例NVG患者16只眼行晶状体玻璃体切除,并撕除晶状体前后囊膜,利用532μm激光行全视网膜光凝,光凝90°~180°的睫状突,观察术后眼压、视力及并发症的情况。结果术后眼压均显著下降（P〈0.01）,1眼矫正视力提高,14眼视力无变化,1例发生视网膜再次出血后视力丧失。14只眼至末次随诊时虹膜及房角新生血管消退;2只眼虹膜表面仍可见纤细的新生血管,但眼压一直控制在20 mm Hg以内。结论 532μm激光全视网膜光凝联合睫状体光凝可有效控制NVG眼压,临时疗效好,无严重并发症,适用于晚期或绝对期青光眼,可在临床广泛开展。

Objective To observe the therapeutic effect of 532 nm laser panretinal photocoagulation combined with ciliary body photocoagulation therapy in the treatment of neovascular glaucoma（NVG）. Methods A total of 16 NVG cases（ 16 eyes）were reviewed in our study. This procedure mainly used panretinal photocoagulation and cyclophotocoagulation with the range of 90 to 180 degree after lensectomy and vitrectomy, and both anterior and posterior capsulorrhexis were performed. The intraocular pressure （IOP）, vision and complications were observed after operation. Results The IOP was significantly declined after operation （ P 〈 0. 01 ） when compared with untreated NVG. In the follow-up, there was 1 case with vision improved, 1 case with vision lost due to the hemorrhage of retina and 14 cases without vision change. During the follow-up period, no neovascular of the iris and anterior chamber angle were found in 14 cases. Neovascular on the surface of iris were observed in two cases. After the surgery,the average IOP was controlled within 20 mmHg. Conclusion The simultaneous treatments with intraocular panretinal photocoagulation and cyclophotocoagulation can deal with NVG. The operation is effective after long time observation and it is a safe and effective way for the end-stage NVG. It could be widely used in clinic.