810 nm激光经巩膜睫状体光凝治疗难治性青光眼的效果

Effects of 810 nm laser trans-scleral cyclophotocoagulation in the treatment of refractory glaucoma

目的观察810 nm激光经巩膜睫状体光凝术(trans-scleral cyclophotocoagulation,TSCP)治疗难治性青光眼的效果。方法回顾性分析2014-04至2016-06保定市第一中心医院收治的78例(78眼)接受810 nm激光TSCP治疗的难治性青光眼患者的临床资料,记录患者术后视力、眼压的变化,观察患者术后眼部疼痛程度,统计治疗相关并发症发生情况。结果 (1)治疗成功73例,成功率为93.59%。(2)术后1 d,患者视力降低13例,术后1周降低11例,术后1、3、6个月患者视力趋向稳定,术后6个月患者视力不变所占比例高达74.36%。视力提升12例,占15.38%;视力降低8例,占10.26%。(3)术后1 d、1周、1个月、3个月、6个月患者眼压均明显降低,与术前比较差异有统计学意义(P<0.05),术后1、3、6个月患者眼压趋向稳定,均低于术后1 d(P<0.05)。(4)术后不同时间所有患者VAS评分均降低,术后1~6个月趋向稳定,明显低于术后1 d及术后1周(P<0.05)。(5)患者术中并发症以眼部疼痛为主,术后早期以前房轻度炎性反应为主,术后晚期并发症发生率较低,以白内障、眼球萎缩、色素膜炎为主。结论 810 nm激光TSCP可降低难治性青光眼患者眼压,减轻眼部疼痛程度,且术后并发症发生率低,安全性高。

Objective To observe the effect of 810 nm laser trans-scleral cyclophotocoagulation （TSCP） on the intraocular pressure （IOP） of patients with refractory glaucoma. Methods The clinical data of 78 patients （78 eyes ） with refractory glaucoma treated with 810 nm laser TSCP in our hospital between April 2014 and June 2016 was analyzed retrospectively. The changes of visual acuity and IOP after surgery were recorded. The degree of eye pain after surgery was observed, and the incidence of related complica- tions was statistically analyzed. Results （ 1 ） The success rate of 810nm laser TSCP in 78 patients with refractory glaucoma was 93.59%. （2） 1 day after surgery, visual acuity declined in 13 cases, and 1 week after surgery, the number of cases decreased to 11. 6 months after surgery, the percentages of patients with unchanged visual acuity, those with improved visual acuity and of patients with decreased visual acuity were 74.36% , 15.38% and 10.26% , respectively. （3）The IOP of patients decreased obviously at 1 day, 1 week, 1 month, 3 months and 6 months after surgery （P 〈 0.05）. 1 month, 3 months and 6 months after surgery, IOP of the patients tended to be stable, and was lower than that at 1 day after surgery （ P 〈 0.05 ）. （4） VAS scores decreased at different time points after surgery. The scores tended to be stable one to 6 months after surgery and were significantly lower than those at 1 day and 1 week after surgery （ P 〈 0.05 ）. （5） The main complication of patients was eye pain, mild inflammation of the anterior chamber was the main com- plication soon after surgery, and the main complications long after surgery included cataract, atrophy of eyeballs and uveitis. Conclusions TSCP can reduce IOP and relieve eye pain in patients with refractory glaucoma. The incidence of complications is low and safety can be ensured.