新生血管性青光眼两种手术方式治疗的临床观察
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Clinical observation of two operation methods for neovascular glaucoma
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    摘要:

    目的:观察两种不同手术方式治疗新生血管性青光眼(neovascular glaucoma,NVG)的临床疗效。

    方法:回顾2008-04/2011-12在我院住院诊断为NVG的患者30例30眼,根据不同手术方式分为两组,A组采用青光眼引流装置Ahmed青光眼阀(Ahmed glaucoma valve, AGV)植入术治疗12例12眼,B组采用半导体二极管激光经巩膜睫状体光凝术(transscleral cyclophotocoagulation, TSCPC)治疗18例18眼。比较两组术后眼压、视力及并发症的情况。

    结果:两组术后眼压与术前相比较均有显著下降(P<0.01)。AGV植入组与TSCPC组术后1wk眼压比较有统计学差异(P<0.05),术后1mo比较无统计学差异(P>0.05)。视力:AGV植入组3眼提高,7眼不变,2眼下降; TSCPC组3眼提高,12眼保持不变,3眼下降。术后并发症:AGV植入组术后早期眼球疼痛、角膜水肿5例(41.7%),术后浅前房3例(25%),前房纤维样渗出2例(16.7%),前房积血3例(25%); TSCPC组术后早期眼球疼痛10例(55.6%),角膜水肿11例(61.1%),前房纤维样渗出5眼(27.8%),前房出血6眼(33.3%)。

    结论:AGV植入术及TSCPC术对于治疗NVG都是有效的方法。AGV植入术是一种滤过性手术,相对较为安全。TSCPC更为经济,适用于晚期或绝对期青光眼。

    Abstract:

    AIM: To evaluate the clinical effect of two different surgical treatments for neovascular glaucoma(NVG).

    METHODS: A total of 30 NVG inpatients(30 eyes)at our hospital from April 2008 to December 2011 were reviewed. Patients were divided into two groups according to the different surgical treatments. In group A, 12 cases(12 eyes)were treated with Ahmed glaucoma valve(AGV)implantation and in group B, 18 cases(18 eyes)were treated with semiconductor diode laser photocoagulation transscleral cyclophotocoagulation(TSCPC). Intraocular pressure, visual acuity and complications were compared between two groups postoperatively.

    RESULTS: The postoperative IOP was significantly lower in each group(P<0.01). There were statistically significant differences(P<0.05)between AGV implantation group and TSCPC group in IOP 1 week after surgery, but there were no statistically significant difference(P>0.05)in IOP 1 month after surgery. Visual acuity: in group A, the visual acuity was improved in 3 eyes, unchanged in 7 eyes and worsened in 2 eyes.; in group B, the visual acuity was improved in 3 eyes, unchanged in 12 eyes and worsened in 3 eyes. Postoperative complications: in group A, eyeball pain and corneal edema were found in 5 cases(41.7%), shallow anterior chamber in 3 cases(25%), anterior chamber fibroid exudation in 2 cases(16.7%), hyphema in 3 cases(25%); in group B, eyeball pain atearly stage after surgery were found in 10 cases(55.6% ), corneal edema in 11 cases(61.1%), anterior chamber fibroid exudation in 5 cases(27.8%), hyphema in 6 cases(33.3%).

    CONCLUSION: AGV implantation and TSCPC are both effective surgical treatment methods for NVG. AGV implantation is a filtration surgery, which is relatively safe. TSCPC is more economical and suitable for glaucoma of advanced or absolute stage.

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陈金鹏,汪荣,徐辉勇,等.新生血管性青光眼两种手术方式治疗的临床观察.国际眼科杂志, 2013,13(11):2259-2261.

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  • 收稿日期:2013-08-19
  • 最后修改日期:2013-10-18
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  • 在线发布日期: 2013-10-28
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