摘要
目的探讨内窥镜下激光睫状体光凝术联合玻璃体切割术治疗糖尿病新生血管性青光眼的临床疗效。方法选取24例(24眼)糖尿病新生血管性青光眼患者,行内窥镜下激光睫状体光凝术联合玻璃体切割术,术后至少随访6个月。观测指标包括手术前后患者视力、眼压变化、新生血管消退程度和术后并发症情况。结果术后视力提高14眼,不变8眼,降低2眼。术后第1天眼压为(29.4±10.8)mm Hg(1 k Pa=7.5 mm Hg),1个月时为(21.0±11.9)mm Hg,最终随访时为(20.1±10.8)mm Hg,与术前(46.6±7.3)mm Hg比较,差异均有统计学意义(均为P<0.05)。术后新生血管完全消失10眼,部分消失残留少量无功能血管者12眼,未见明显改善者2眼。术后第1天8例患者发生颜面部浮肿;术后发生球结膜混合充血9眼、角膜水肿4眼、一过性高眼压4眼、复发性玻璃体出血1眼(后行玻璃体腔灌洗术后病情稳定)。结论内窥镜下激光睫状体光凝术联合玻璃体切割术治疗糖尿病新生血管性青光眼短期内临床效果显著,并发症少,患者痛苦少,是一种相对有效、安全的手术方法。
Objective To analyze the clinical effects and safety of endoscopic cyclophotocoagulation combined with vitrectomy on diabetic neovascular glaucoma ret- rospectively. Methods Twenty-four patients （ 24 eyes ） with diabetic neovascular glaucoma were chosen. All the patients were performed endoscopic cyclophotocoagula- tion （ECP）, according to the preoperative intraocular pressure （IOP） and new vessels. IOP,visual acuity, new vessels fading degree and complications were observed before and after surgery. All patients were received at least six months follow-up after the treatment. Results After treatment, the visual acuity of the patients was improved in 14 eyes, stabled in 8 eyes, reduced in 2 eyes. The average IOP before treatment and at 1 day, l month,5 months after treatment were （45.5 _＋ 7.33 ） mmHg （ 1 kPa = 7.5 mmHg）, （29.4 ＋ 10.84） mmHg, （21.0 ＋ ll. 9） mmHg and （20.1 _＋ 10.8） mmHg,respectively. After operation,the new vessels were disappeared in l0 eyes, 12 eyes with a small amount of no functional residual vessels,2 eyes with no improvement. Postoperative complications were facial edema （8 cases）, mixed conjunctival congestion （9 cases）, corneal edema （4 cases） ,transient high IOP （4 cases） and recurrent vitreous hemorrhage （ 1 case）. Conelusion Endoscopic cyclophotocoagulation combined with vitrectomy for diabet- ic neovascular glaucoma has obvious clinical effect during a short time follow up. It is a relatively effective and safe surgical method with few complications and less pain.
出处
《眼科新进展》
CAS
北大核心
2016年第10期973-975,共3页
Recent Advances in Ophthalmology
