玻璃体切除术联合睫状体光凝治疗外伤性青光眼的效果观察

Effect of pars plana vitrectomy combined with endoscopic cyclophotocoagulation on traumatic glaucoma

目的研究玻璃体切除术(PPV)联合睫状体光凝(ECP)治疗外伤性青光眼的效果。方法随机对照研究。抽取2020年1月至2023年1月南阳市眼科医院收治的外伤性青光眼患者50例,按随机数字表法分为对照组和研究组,每组25例。对照组采用PPV治疗,研究组采用PPV联合直视下ECP治疗。比较两组术后6个月视力,比较两组术后7 d、1个月、3个月、6个月眼压变化,比较两组并发症发生率。结果术后6个月,研究组视力提高率(72.00%,18/25)高于对照组(36.00%,9/25),P<0.05。术后7 d、1个月、3个月、6个月,研究组眼压均低于对照组(P均<0.05)。研究组并发症发生率(8.00%,2/25)与对照组(24.00%,6/25)比较差异未见统计学意义(P>0.05)。结论PPV联合直视下ECP治疗外伤性青光眼的效果显著,能扩大光凝范围,缩短激光持续时间,提升患者视力,降低眼压,减少并发症的发生。

Objective To investigate the effect of pars plana vitrectomy(PPV)combined with endoscopic cyclophotocoagulation(ECP)in the treatment of traumatic glaucoma.Methods This study was a randomized controlled trail.A total of 50 patients with traumatic glaucoma treated in Nanyang Eye Hospital from January 2020 to January 2023 were selected,and they were divided into control group and study group by random number table method,with 25 cases in each group.The control group was treated by PPV,and the study group was treated by PPV combined with ECP under direct vision.The 6-month postoperative visual acuity of the two groups were compared.The intraocular pressure of the two groups were compared 7 days,1 month,3 months,and 6 months after surgery.The incidence of complications of the two groups were compared.Results The visual acuity improvement rate of the study group(72.00%,18/25)was higher than the that of the control group(36.00%,9/25)6 months after treatment(P<0.05).The intraocular pressure in the study group was lower than that in the control group 7 days,1 month,3 months,and 6 months after surgery(all P<0.05).There was no significant difference in the incidence of complications between the study group(8.00%,2/25)and the control group(24.00%,6/25),P>0.05.Conclusions PPV combined with ECP under direct vision is effective in the treatment of traumatic glaucoma.It can expand the range of photocoagulation,shorten the duration of laser,improve the visual acuity of patients,reduce intraocular pressure and incidence of complications.