摘要
目的:了解新生血管性青光眼810nm激光经巩膜睫状体光凝的临床疗效。方法:药物和手术无法控制的新生血管性青光眼。39例39眼。其中原发性青光眼多次手术失败者24例,继发性青光眼11例,外伤性青光眼4例。光纤和视轴近似平行,用2s时间在睫状体上产生烧灼点。一般情况下360°打40点,对于有视力者180°打20点,对于眼压在70mmHg以上者行360°打2排80点。结果:激光后经随访1～12(平均6)mo,眼压控制在24mmHg(1mmHg=0.133kPa)以下31例(79%);眼压仍在30～40mmHg5例(13%);仍高于40mmHg以上3例(8%),行第2次光凝,眼压仍高者,最终眼球摘除术。无光感35例(90%);有视力4例(10%),其中视力无改变2例(5%);视力下降1例(2%)。前房出血9例(23%);前房闪辉12例(31%);角膜后沉淀物(KP)8例(20%),2wk后消失。结论:810nm激光经巩膜睫状体光凝治疗对药物和手术无法控制的新生血管性青光眼有效安全,还可保存眼球,解除痛苦。
· AIM: To evaluate the clinical effects of intraocular pressure (IOP) reduction by trans-scleral 810nm diode laser clophotocoagulation in cases of neovascular laucoma.· METHODS: Thirty-nine eyes of 39 patients refractory to alternative treatments were selected to undergo cyclodiode treatment, among whom there were 24 cases of post-operation primary glaucoma, 11 cases of secondary glaucoma and 4 cases of traumatic glaucoma clophotocoagulation procedure was conducted as follows: optical fiber was placed parallel to the visual axis for 2s to produce cautery points. Generally 40 cauteries/360° and 20 cauteries/180°for visual patients, and 80 cauteries in 2 rows for patients with IOP above 70mmHg.· RESULTS: During the follow-up of 1-12mo (mean 6mo), the IOP was kept under 24mmHg in 31 cases (79%), 30-40mmHg in 5 cases (13%) and still above 40mmHg in 3 cases (8%) who had persistent high IOP after the second cyclodiode treatment and underwent ophthalmectomy finally. AS for the visual acuity, 35 cases (90%) had no light perccption and the other 4 cases (10%) had visual acuity, among whom 2 cases (5%) had unchanged visual acuity and 1 case (2%) had deteriorated visual acuity. Postoperative complications included anterior chamber haemorrhage in 9 cases (23%), aqueous flare in 12 cases (31%) and keratic precipitates (disappeared 2wk later) in 8 cases (20%).· CONCLUSION: Diode laser cycloablation is relatively safe and effective on controlling IOP in eyes with neovascular glaucoma which are refractory to medicamentous and surgical treatments. Thus patients can obtain more chances to have their eyes saved and suffering reduced.·
出处
《国际眼科杂志》
CAS
2005年第2期263-264,共2页
International Eye Science
