两种术式治疗难治性青光眼的疗效分析

Therapeutic effect of two surgical methods for refractory glaucoma

目的:观察高聚焦超声睫状体成形术(UCP)和睫状体冷冻术治疗难治性青光眼的临床疗效。方法:回顾性研究2018-01/10于我院就诊的难治性青光眼患者50例50眼,其中30眼实施UCP(UCP组),20眼实施睫状体冷冻术(冷冻组)。术后随访3mo,观察患者眼压,评估眼球疼痛等级和并发症发生情况。结果:UCP组术后1d,1wk,1、3mo平均眼压分别为29.27±10.40、23.87±8.61、25.27±9.95、23.70±10.06mmHg,与术前眼压(43.97±10.39mmHg)相比显著降低(P<0.01);冷冻组术后1d,1wk,1、3mo平均眼压分别为22.15±7.78、20.80±8.44、22.50±7.12、24.20±8.43mmHg,与术前眼压(47.30±8.53mmHg)相比显著降低(P<0.01)。UCP组术后1d,1wk,1、3mo的疼痛等级评分均较术前下降(P<0.05);冷冻组术后1d与术前相比疼痛等级评分无差异(P>0.05),术后1wk,1、3mo患者的疼痛等级评分均较术前下降(P<0.05)。UCP组5眼(17%)出现轻微并发症,冷冻组16眼(80%)出现并发症。结论:UCP能显著缓解难治性青光眼患者的疼痛,有效降低眼压,且术后副作用较小。

AIM:To observe the clinical efficacy and safety in the treatment for refractory glaucoma by two kinds of cyclodestructive procedures.METHODS:A retrospective study of 50 patients(50 eyes)with refractory glaucoma diagnosed in our hospital between January 2018 and October 2018.Ultrasound cyclo plasty(UCP)were performed on 30 eyes and cyclocryotherapy were performed on 20 eyes,introcular pressure(IOP),pain grade scores and complications after operation were followed up.RESULTS:The average IOP of the UCP group on 1d,1wk,1mo and 3mo were 29.27±10.40,23.87±8.61,25.27±9.95,23.70±10.06mmHg compared with 43.97±10.39mmHg before operation.The average IOP of the cyclocryotherapy group on 1d,1wk,1mo and 3mo were 22.15±7.78,20.80±8.44,22.50±7.12,24.20±8.43mmHg compared with 47.30±8.53mmHg before operation.The IOP in both group was significantly reduced(P<0.01).The pain grade scores of patients in the UCP group at 1d,1wk,1mo and 3mo after surgery were significantly lower than those before operation(P<0.05),but there was no significant difference in the cyclocryotherapy group at 1d after surgery(P>0.05).There were no serious complications in the UCP group,four eyes appeared conjunctival hyperemia and one eye appeared superficial punctuate keratitis;but there were 16 eyes(80.00%)in the cyclocryotherapy group:ten eyes appeared conjunctival hyperemia and six eyes appeared anterior chamber hemorrhage.CONCLUSION:UCP is safe and convenient surgery for refractory glaucoma,and has significant effect on reducing intraocular pressure,alleviating ocular pain and decreasing complications.