综合手术治疗晚期新生血管性青光眼的临床观察

Clinical observation of comprehensive operation for advanced neovascular glaucoma

目的：观察综合手术治疗晚期新生血管性青光眼的疗效。方法：对2010-10/2013-10期间在我院住院的39例39眼晚期新生血管性青光眼患者使用视网膜及睫状体冷凝联合小梁切除术及前部玻璃体切除术治疗的临床资料进行回顾性分析。结果：所有患者出院后随访6-12mo。39例术后第1wk眼压（12.94±2.33mm Hg）较术前眼压（57.31±6.72mm Hg）明显降低,患者疼痛明显缓解。随访12mo时35例不用降眼压药物眼压为17.25±2.24mm Hg,4例用1-2种降眼压药物治疗眼压〈21mm Hg。39例虹膜及房角新生血管均有不同程度回退。34例结膜滤过泡弥散隆起,5例较扁平。术后无浅前房或眼球萎缩。结论：视网膜及睫状体冷凝联合小梁切除术及前部玻璃体切除术治疗晚期新生血管性青光眼,能有效降低眼压,改善患者临床症状,为一种较安全而有效的综合性治疗方法。

AIM：To observe the clinical effect of comprehensive operation for neovascular glaucoma（NVC）.METHODS：Thirty-nine cases（39 eyes） with late neovascular glaucoma in our hospital from October 2010 to October 2013 were treated with cyclocryotherapy,retina condensation combined with trabeculectomy and anterior vitrectomy.The clinical data were retrospectively analyzed.RESULTS：All the patients were followed up for 6-12mo.The mean postoperative intraocular pressure（IOP）of 39 cases（39 eyes） was 12.94 ±2.33mmHg（1mmHg=0.133kPa） at 1wk,compared with preoperative IOP（57.31 ±6.72mmHg）,which was decreased obviously.The pain was alleviated.During follow-up period,IOP of 35 eyes was normal（17.25±2.24 mm Hg） without using IOPlowing drugs and the postoperative IOP was decreased to the normal range after using 1-2 kinds of drugs in 4cases.The iris neovascularization of all patients eliminated at different extent.Conjunctival filtering blebs of 34 cases were dispersion and those of 5 cases were flat.No shallow anterior chamber or eyeball atrophy occurred during follow-up period.CONCLUSION：The therapy of cyclocryotherapy,retina condensation combined with trabeculectomy and anterior vitrectomy is safe and effective to reduce IOP and relieve suffering in patients with NVG.