手术显微镜直视下睫状体光凝术治疗难治性青光眼

Cyclophotocoagulation under operating microscopy for the treatment of refractory glaucoma

目的评估手术显微镜直视下睫状体光凝术治疗难治性青光眼的效果。方法病例系列分析。回顾性分析2017年1月至2018年4月该院眼科难治性青光眼31例(31眼)的临床资料。患者均接受手术显微镜直视下平坦部入路睫状体光凝术。术后随访至少12个月。结果术前眼压(34.8±8.5)mmHg(1 mmHg=0.133 kPa),术后1天、7天、1个月、6个月和12个月眼压分别为(18.5±6.3)mmHg、(17.1±3.7)mmHg、(16.4±2.7)mmHg、(16.2±2.9)mmHg和(16.2±3.2)mmHg,术后各时间点眼压均低于术前眼压,差异均有统计学意义(P=0.000)。随访末期的手术成功率为74.2%。术后UBM检查示光凝处的睫状突完全萎缩。结论手术显微镜直视下睫状体光凝术治疗难治性青光眼安全有效。

Objective To evaluate the efficacy of cyclophotocoagulation under operating microscopy for the treatment of refractory glaucoma.Methods The clinical data of 31 eyes of 31 cases with refractory glaucoma from Jan.2017 to Apr.2018 in this hospital were analyzed retrospectively.All patients underwent cyclophotocoagulation under operating microscopy via pars plana.The follow-up time was 12 months at least.Results Preoperative intraocular pressure(IOP)was(34.8±8.5)mmHg(1 mmHg=0.133 kPa).Postoperative IOP at 1 day,7 days,1,6 and 12 months were(18.5±6.3)mmHg,(17.1±3.7)mmHg,(16.4±2.7)mmHg,(16.2±2.9)mmHg and(16.2±3.2)mmHg,respectively.The difference were statistically significant between before and after operation(P=0.000).The success rate of surgery at the end of follow-up was 74.2%.Postoperative ultrasonic biomicroscopy showed the complete atrophy of ciliary body in the cyclophotocoagulation sites.Conclusion Cyclophotocoagulation under operating microscopy was effective and safe for the treatment of refractory glaucoma.