摘要
目的探讨眼内窥镜辅助下的睫状体光凝联合小梁切开术治疗原发性开角型青光眼的有效性和安全性。方法回顾性分析徐州医科大学附属徐州市立医院2020年1月至2021年5月接受眼内窥镜辅助的睫状体光凝联合小梁切开术的晚期原发性开角型青光眼伴白内障患者30例(30眼)病历资料。记录术前最佳矫正视力、术前眼压、局部降眼压药物数量;术后1 d、术后3个月、术后6个月、术后1年眼压及局部降眼压药物用量;术后并发症;条件成功例数及完全成功例数。结果所有患者随访至术后1年。术后1年时最佳矫正视力26眼提高一行以上;3眼维持术前视力;1眼视力下降。术后1 d、术后3个月、术后6个月、术后1年的眼压及局部降眼压药物数量与术前比较差异均有统计学意义(P<0.01)。术后1年时治疗条件成功8例,完全成功17例。早期前房积血30眼,一过性高眼压3眼,睫状体脱离0眼,角膜水肿9眼,前房渗出8眼(26.7%)。结论随访12个月的小样本量研究结果显示,眼内窥镜辅助下的睫状体光凝联合小梁切开术治疗晚期开角型青光眼初步疗效和安全性较好,但仍需要大样本病例进一步研究其长期安全性和有效性。
Objective To investigate the curative effect of endoscopic cyclophotocoagulation combined with trabeculectomy for primary open angle glaucoma.Methods From January 2020 to May 2021,30 eyes of 30 patients with advanced primary open angle glaucoma with cataract who underwent endoscopic cyclophotocoagulation combined with trabeculectomy in the Municipal Hospital Affiliated to Xuzhou Medical University were retrospectively analyzed.The preoperative best corrected visual acuity,preoperative intraocular pressure(IOP)and numbers of anti-glaucoma medication were recorded.IOP,numbers of anti-glaucoma medication at 1 day,3 months,6 months and 1 year after operation,postoperative complications,the numbers of absolute success and qualified success were recorded.Results All cases were followed up for 1 year.The best corrected visual acuity improved by more than one line in 26 eyes at 1 year after operation.Preoperative visual acuity was maintained in 3 eyes visual acuity decreased in 1 eye.The IOP and numbers of anti-glaucoma medication at 1 day,3 months,6 months and 1 year after operation were significantly different from those before operation(P<0.01).At 1 year after operation,8 patients were qualified successful and 17 patients were absolutely successful.Early hyphema in 30 eyes,transient ocular hypertension in 3 eyes ciliary body detachment in 0 eyes,corneal edema in 9 eyes,and anterior chamber exudation in 8 eyes.Conclusions In this small sample size of study with follow-up for 12 months,the results showed that endoscopic cyclophotocoagulation combined with trabeculectomy in the treatment of advanced open angle glaucoma has good preliminary efficacy and safety.However,a large sample of cases is still needed to further study its long-term safety and efficacy.
作者
丁文君
陈霄雅
卢亚楠
王瑞雪
李华
Ding Wenjun;Chen Xiaoya;Lu Yanan;Wang Ruixue;Li Hua(Department of Ophthalmology,Municipal Hospital Affiliated to Xuzhou Medical University,Xuzhou First People′s Hospital,Xuzhou Eye Research Institute,Xuzhou 221000,China)
出处
《中国医师进修杂志》
2023年第5期390-394,共5页
Chinese Journal of Postgraduates of Medicine
基金
江苏省青年医学重点人才培养计划(QNRC2016364)。
