半导体激光透巩膜睫状体光凝治疗难治性青光眼的护理观察

Nursing Care of Refractory Glaucoma Treated with Transscleral Diode Laser Cyclophotocoagulation

目的 评价利用半导体激光透巩膜睫状体光凝治疗难治性青光眼的效果 ,探讨其临床护理观察的要点。方法对 34例难治性青光眼患眼进行 810nm半导体激光透巩膜睫状体光凝治疗 ,能量为 15 0 0～ 2 2 5 0mW ,时间为 2s ,范围 <180° ,观察 3～ 6个月的治疗效果和并发症。结果 治疗前眼压为 (5 1± 3.7)mmHg ,经过第 1次治疗后的眼压是 (18± 2 .1)mmHg(P <0 .0 1) ,最后统计的眼压是 (17± 1.6 )mmHg(P <0 .0 1)。并发症主要是前房炎症反应 ,在 2周左右消失。结论 透巩膜半导体激光睫状体光凝是治疗难治性青光眼的一种有效的方法 ,而且操作方便 ,患者痛苦小。围手术期的护理工作主要是观察视力和眼压的变化 。

To evaluate the outcome of contact transscleral diode laser cyclophotocoagulation (CTDC) in the treatment of refractory glaucoma.Methods Included in the study were 34 eyes with refractory glaucoma receiving treatment of 1.5 2.25 W applied for 2 seconds, not over 180 deg.The patients were followed up for at least three months.Results The mean pretreatment intraocular pressure (IOP) was (51±3.7)mmHg(24 59mmHg). After the first treatment, there was significant decrease in IOP and the mean IOP was (18±2.1)mmHg(12 35mmHg)(P<0.01),and (17±1.6)mmHg(13 31mmHg)(P<0.01)by the time of follow up. The success rate was 85.3%(29 of 34)after the first diode laser therapy, and increased to 94.1% (32 of 34) after re treatment. The most common complications were conjunctival hyperemia and anterior chamber reaction, which diminished within 2 weeks. Increase or decrease in visual acuities were not noted.Conclusion CTDC is a safe and effective therapy for advanced refractory glaucoma.CTDC may become the surgical procedure of choice for secondary glaucoma caused by severe injury and vitrectomy, and for scleritis associated glaucoma.