半量睫状体光凝治疗难治性青光眼的临床观察

Efficacy of half-dose cyclophotocoagulation for refractory glaucoma

目的观察半量睫状体光凝术治疗难治性青光眼中的疗效,并评估前房注射曲安奈德对抑制睫状体光凝术后炎症反应的作用。方法收集2019年2~12月在首都医科大学附属北京世纪坛医院眼科接受半量睫状体光凝治疗的难治性青光眼患者(术中前房注射曲安奈德1.0 mg)。记录并分析患者的一般资料、术前和术后不同随访时间点的视力、眼压、炎症反应及并发症等。结果本研究共纳入患者17例(20只眼),平均随访时间为(22.36±19.72)周。术后第1天大多数患者为轻度前房反应,无严重角膜水肿。末次随访时术后视力改善者5只眼(25.0%),视力保持不变者11只眼(55.0%),视力下降者4只眼(20.0%),无视力严重下降。眼压由术前平均眼压(33.47±6.04)mmHg降至末次随访时(17.34±9.86)mmHg(P<0.05)。20只眼均未出现严重并发症。结论半量睫状体光凝能够安全有效地降低难治性青光眼患者眼压,曲安奈德对抑制睫状体光凝术后炎症反应有较好效果。

Objective To observe the efficacy of half-dose cyclophotocoagulation in the treatment of refractory glaucoma,and evaluate the effect of anterior chamber injection of triamcinolone acetonide on inhibiting the inflammatory response after cyclophotocoagulation.Methods A total of 17 patients(20 eyes)with refractory glaucoma who underwent half-dose cyclophotocoagulation and intraoperative anterior chamber injection of triamcinolone acetonide(1.0 mg)in the department of ophthalmology,Beijing Shijitan Hospital,Capital Medical University from February 2019 to December 2019 were enrolled.The general information of the patients,pre-and post-surgical visual acuity,intraocular pressure(IOP),inflammatory response and complications at different follow-up time points were recorded and analyzed.Results A total of 17 patients(20 eyes)were included in this study and followed up for 22.36±19.72 weeks(10.97~33.75 weeks).Most patients had mild anterior chamber reaction without severe corneal edema on postoperative day 1.At the last follow-up,the visual acuity improved in 5 eyes(25.0%),remained the same in 11 eyes(55.0%),and decreased in 4 eyes(20.0%),and no serious decline in vision was observed.The IOP decreased from 33.47±6.04 mmHg to 17.34±9.86 mmHg(P<0.05).None of the 20 eyes had serious complications.Conclusions Half-dose cyclophotocoagulation can safely and effectively decrease IOP in patients with refractory glaucoma,and triamcinolone acetonide is effective in inhibiting inflammatory response after cyclophotocoagulation.