透巩膜睫状体光凝治疗难治性青光眼的疗效观察

目的 评价半导体激光透巩膜睫状体光凝治疗难治性青光眼的临床疗效.方法 取38只眼难治性青光眼,眼压30.9-66.23mmH,平均(45.1±12.98)mmHg,应用激光能量1500～2500mW,脉冲2s,治疗范围270°-300°,观察术后1d、1周、1和3月时患眼的眼压,疼痛情况和并发症.结果 (1)术后1d眼压9.3-33.1mmHg,平均(24.47±8.51)mmHg,术后1周眼压7.5-32.5mmHg,平均(21.67±7.92)mmHg,术后1月眼压5.8～35.5mmHg,平均为(21.02±10.7)mmHg,术后3月眼压4.2-35.8 mmHg,平均(20.03±9.82)mmHg.术后各时间点眼压与术前眼压配对t检验,t值分别为7.11、10.09、8.82和10.03,均P＜0.0001,差异有统计学意义;(2)术后34只眼(89.47%)疼痛明显缓解;(3)并发症有球结膜灼伤水肿2只眼,前房积血23只眼,葡萄膜炎反应18只眼,角膜上皮脱落2只眼.结论 透巩膜睫状体光凝创伤小,早期治疗效果明显,操作简便,能有效降低眼压,缓解难治性青光眼的疼痛.

Transscleral diode laser cyclophotocoagulation for refractory glaucoma

Objective To evaluate the outcome of transscleral diode laser cyclophotocoagulation on eyes with refractory glaucoma. Methods Of 38 eyes with refractory glaucoma (IOP: 30.9-66.23 mmHg, mean 45.1±12.98 mmHg) were received the laser treatments with 1500-2500W applied for 2 seconds, 270～ 300deg.Intraocular pressure, pain and complications were observed at 1 day, 1week, 1 month and 3 months after surgery. Results One day after surgery IOP was 9.3-33.1 mmHg, mean at (24.47 ± 8.51) mmHg, after 1week IOP 7.5-32.5mmHg, mean (21.67± 7.92) mmHg, after 1 mom IOP 5.8-35.5mmHg, mean (21.02±1 0.7) mmHg, after 3 months IOP 4.2-35.8 mmHg, mean (20.03 ± 9.82) mmHg. The observation time point of IOP and preoperative IOP paired t test, t values were 7.11, 10.09, 8.82 and 10.03 at different time points,both P ＜0.0001, had a statistical significant difference. The pain of 34 eyes (89.47%) eased significantly after surgery. The most common complications were conjunctival burns (2 eyes), uveitis reaction (18 eyes), hyphema (23 eyes), and corneal epithelial shedding (2 eyes). Conclusions Transscleral diode laser cyclophotocoagulation is easy to operate and can effectively lower intraocular pressure to ease the pain of refractory glaucoma in the early stage.