睫状体平坦部滤过术治疗虹膜角膜内皮综合征继发青光眼的初步观察

Clinical study on pars plana filtration technique for treatment of secondary glaucoma caused by ICE syndrome

目的观察睫状体平坦部滤过术治疗虹膜角膜内皮综合征(ICE综合征)继发青光眼的临床疗效。方法回顾性分析中国中医科学院眼科医院2013年2月—2016年5月接受睫状体平坦部滤过术治疗的虹膜角膜内皮综合征继发青光眼患者10例。观察手术对ICE综合征继发青光眼患者眼压、角膜内皮、视力、前房深度变化,并对术中及术后并发症进行统计。结果术后随访1年,眼压显著低于术前(t=8. 79,P <0. 001);术前、术后角膜内皮计数比较,差异无统计学意义(P> 0. 05);至末次随访术眼视力提高6眼,不变3眼,1眼术前即无光感。术前、术后1年前房深度差异无统计学意义(P> 0. 05);至末次随访均未见脉络膜脱离、视网膜脱离、低眼压眼球萎缩等并发症。结论睫状体平坦部滤过术是一种安全、有效、方便的手术方法 ,较少出现常规青光眼术后浅前房、角膜内皮损伤等并发症,且不会进一步损伤角膜内皮。特别适用于治疗虹膜角膜内皮综合征等角膜内皮计数少青光眼患者。

Objective To assess the effect of pars plana filtration technique for glaucoma surgery on secondary glaucoma caused by iridocorneal endothelial syndrome iridocorneal endothelial （ICE） syndrome. Methods A retrospective analysis was done of the clinical and surgical data from 10 patients with secondary glaucoma caused by ICE syndrome who underwent surgery using pars plana filtration technique. A long-term follow-up was done to evaluate the efficacy and safety of the surgery on the secondary glaucoma. Results After 1 year of following up,pars plana filtration technique for glaucoma surgery was effective and safety for the treatment of glaucoma. The best corrected vision of preoperative and postoperative was stable and had rare severe surgical complications. The postoperative intraocular pressure was decreased obviously. There were no significant differences between pre-operative and post-operative group at the mean counts of endothelial cells,and at the mean depth of anterior-chamber （ P 〉0.05）, respectively. Conclusion Pars plana filtration technique was effective and safety for the treatment of glaucoma with high successful rate. It has no severe postoperative complications associated with the operation.