论文部分内容阅读
目的评估半导体激光经巩膜睫状体光凝治疗青光眼的疗效及安全性。方法对１０２例患者的１０５只药物无法控制眼压且又不宜行滤过手术的重症青光眼（眼压３４～８２ｍｍＨｇ，平均４４ｍｍＨｇ±１１ｍｍＨｇ），通过Ｇ探头行半导体激光经巩膜睫状体光凝治疗，激光功率１５～２０Ｗ，脉冲时间２ｓ，避开颞侧９０°，在剩余的２７０°范围内击射１２～２０点，点间距２ｍｍ。以激光治疗后眼压≤２１ｍｍＨｇ且除外眼球萎缩为治疗成功。结果治疗后经过６～１８个月（平均１２．５个月）的随访观察，治疗成功率达７２．４％（７６／１０５），疼痛控制率为９５．２％（５９／６２）。治疗后平均眼压为２０ｍｍＨｇ±８ｍｍＨｇ，较治疗前下降５５％（Ｐ＜０．００１）。每天使用降眼压药物次数由治疗前的２７±０９减至１３±１１，减少５２％（Ｐ＜０．０５）。晚期并发症有慢性色素膜炎（５眼，４．８％）、眼球萎缩（４眼，３．８％）、光感丧失（４眼，３．８％）和低眼压（３眼，２．９％）。结论半导体激光经巩膜睫状体光凝是治疗难治性青光眼相对安全、简便、副作用小的有效方法。
Objective To evaluate the efficacy and safety of semiconductor laser in the treatment of glaucoma by scleral ciliary body photocoagulation. Methods Totally 105 eyes of 102 patients with intraocular pressure (IOP) were treated with intraocular pressure (34 ~ 82mmHg, average 44mmHg ± 11mmHg), and treated by semi-conductor laser scleral ciliary body photocoagulation , The laser power 1 5 ~ 2 0W, pulse time 2s, avoiding the temporal side 90 °, shot in the remaining 270 ° range of 12 to 20 points, the point spacing 2mm. After laser treatment IOP ≤ 21mmHg and except for the atrophy of the eye for the treatment of success. Results After 6 to 18 months (mean 12.5 months) follow-up after treatment, the success rate was 72.4% (76/105) and the pain control rate was 95.2% (59/62). After treatment, the average intraocular pressure was 20mmHg ± 8mmHg, 55% lower than before treatment (P <0.001). The number of antihypertensive drugs used per day decreased from 27 ± 09 before treatment to 1 3 ± 1 1, a reduction of 52% (P <0.05). Late complications were chronic uveitis (5 eyes, 4.8%), atrophy (4 eyes, 3.8%), loss of light sensation (4 eyes, 3.8%) and low intraocular pressure (3 eyes, 2.9%). Conclusions Semiconductor laser transscleral ciliary body photocoagulation is an effective and safe method for the treatment of refractory glaucoma.