超声睫状体成形术治疗晚期青光眼的效果

Efficacy of ultrasound cyclo-plasty for the treatment of advanced glaucoma

目的评价超声睫状体成形术(UCP)治疗晚期青光眼的安全性和有效性。方法对2018年8月至2018年9月药物无法控制眼压的晚期青光眼13例(14只眼)采用UCP治疗的临床资料进行回顾性分析。UCP术前视力2只眼光感,其余12只眼均无光感。结果术后随访2个月。所有UCP操作时间均在5 min以内。术前平均眼压(51.86±9.75)mmHg(1 mmHg=0.133 kPa),术后1天、1周、1个月及2个月较术前眼压分别下降33.07%、47.41%、63.56%和64.05%。末次随访时,应用局部降眼压药物情况下,眼压<21 mmHg者10只眼,22~30 mmHg者2只眼,31~40 mmHg者2只眼,平均眼压(18.64±11.27)mmHg,与术前比较差异具有统计学意义(P<0.01)。术后视力无提高。随访期间未出现前房积血、眼表破坏、晶状体移位、视网膜脱离、眼内炎或交感性眼炎等并发症。结论UCP能有效而安全地降低药物无法控制的晚期青光眼眼压,无明显并发症。

Objective To evaluate the safety and efficacy of ultrasound cyclo-plasty (UCP) in patients with advanced glaucoma. Methods The clinical data of 14 eyes of 13 cases of advanced glaucoma from Aug. 2018 to Sep. 2018 whose IOP could not be managed were retrospectively analyzed. All cases received UCP. Before surgery BCVA was light perception in 2 eyes and no light perception in 12 eyes. Results All patients were followed up for 2 months. The surgery was completed within 5 minutes. The average IOP was (51.86+ 9.75) mmHg before surgery. The decrease rate of IOP in patients were 33.07%、47.41%、63.56% and 64.05%, respectively at 1 day, 1 week, 1 month and 2 months after surgery. At the lastest follow-up, IOP after local hypotensive drug treatment was <21 mmHg in 10 eyes, 22- 30mmHg in 2 eyes, 31- 40 mmHg in 2 eyes. The IOP average was (18.64±11.27)mmHg after UCP. The difference was statistically significant between before and after UCP (P<0.01). Visual acuity of all cases were not improved. No complication such as hyphema, ocular surface destruction, luxation of lens, retinal detachment, endophthalmitis or sympathetic ophthalmia occurred. Conclusion UCP can effectively and safely reduce uncontrolled IOP despite maximally tolerable anti-glaucoma medications of advanced glaucoma, and there is no obvious complication.