超声睫状体成形术治疗新生血管性青光眼的疗效及安全性

Clinical effect and safety of ultrasound cyclo-plasty in the treatment of neovascular glaucoma

目的:评价超声睫状体成形术(UCP)治疗新生血管性青光眼(NVG)的有效性与安全性。方法:收集2018-01/12于我院实施UCP治疗的NVG患者30例30眼,分别于术前、术后1、3d,1wk,1、2、3、6mo评估并记录视力、眼压、疼痛程度及降眼压药物使用数量,并观察术后并发症发生情况。结果:本组患者术后各时间点视力均较术前[1.63±0.59(LogMAR)]改善,疼痛程度评分均较术前[2(1,4)分]降低,降眼压药物使用数量均较术前[4,(4,4)种]减少,眼压均较术前(44.19±13.72mmHg)明显降低(均P<0.01),眼压降低率依次为57.32%、56.45%、56.82%、55.64%、52.37%、50.20%、49.18%,且术后6mo时眼压下降值与术前眼压相关(r=0.928,P<0.001)。随访至术后6mo,本组患者手术成功8眼(31%),部分成功7眼(27%),失败11眼(42%),失访4眼,术后未见严重并发症发生。结论:UCP治疗NVG可有效降眼压,减轻患者眼部疼痛,并发症少,安全性高,且术前眼压越高,术后降眼压效果越明显。

·AIM:To evaluate the efficacy and safety of ultrasound cycloplasty(UCP)in the treatment of neovascular glaucoma(NVG).·METHODS:Thirty patients(30 eyes)with NVG who were treated with UCP at our hospital from January 2018 to December 2018 were collected.All patients received comprehensive ophthalmic examination.Visual acuity,best corrected visual acuity(BCVA),intraocular pressure(IOP),pain grade score,ocular surface,number of glaucoma drugs and complications were recorded before and 1,3d,1wk and 1,2,3,6mo after operation,and the efficacy and safety were evaluated.·RESULTS:The postoperative visual acuity was improved,the pain score was decreased,and the use of intraocular pressure-lowering drugs was decreased and the IOP decreased significantly(P<0.01).The preoperation visual acuity,pain score,use of intraocular pressure-lowering drugs and IOP was[1.63±0.59(LogMAR)],[2(1,4)],[4(4,4)]and(44.19±13.72)mmHg.The postoperative IOP were decreased at different observation time within 6mo,and the differences with preoperative IOP were statistically significant(all P<0.01).The IOP decrease rates were 57.32%,56.45%,56.82%,55.64%,52.37%,50.20%and 49.18%on 1d,3d,1wk,1mo,2mo,3mo and 6mo after surgery respectively.On 6mo after treatment,8 eyes(31%)IOP were complete controlled,7 eyes(27%)were partially controlled,11 eyes(42%)cannot be controlled,and 4 eyes were lost to follow-up.The IOP reduction on 6mo of postoperation was significantly correlated with that of preoperation(r=0.928,P<0.001).The number of glaucoma drugs and pain scores were decreased,and the differences with that of preoperation were statistically significant(P<0.01),and the BCVA were improved,the differences were statistically significant(P<0.01).There was no serious complications were occurred in all patients after operation.·CONCLUSION:UCP is high safety and few complications for NVG treatment.It has significant effect on reducing IOP,relieving ocular pain.The higher the preoperation IOP,the greater the IOP reduction after surgery.It was a promising anti-glaucoma method.