无晶状体青光眼睫状突激光手术疗效观察

目的:评价经扁平部巩膜切口直视下行睫状突激光手术治疗无晶状体眼性青光眼的疗效。方法:对20例(20只眼)无晶状体眼性青光眼作扁平部三切口,行前段玻璃体切割,术中将532半导体激光器导管经扁平部切口插入,在眼内照明直视下进行180°范围的睫状突光凝治疗。术后观察视力、眼压、眼前段组织反应等,平均随访时间13个月。结果:本组患者术前眼压与术后最后一次随访眼压(39.75±6.27vs21.35±2.52)mmHg]比较,差异有统计学意义(P=0.000)。术后第1、3个月时睫状体超声生物显微镜检查,术区睫状突有萎缩性改变。结论:经扁平部巩膜切口直视下行睫状突光凝术治疗无晶状体眼性青光眼能有效地降低眼压。

Therapeutic effect of laser photocoagulation of ciliary processes in aphakic glaucoma

OBJECTIVE: To evaluate the therapeutic effect of laser photocoagulation of ciliary processes after pars plana vitrectomy in aphakic glaucoma. METHODS: Twenty patients (20 eyes) of aphakic glaucoma underwent vitrectomy plus laser treatment. During the surgery, after conventional 3-incision pars plana vitrectomy, a probe of semi-conductor diode laser (532 nm) was inserted through the sclera incision, the ciliary processes were then photocoagulated under direct visualization for 180 degree range. Before and after the surgery, the visual acuity, the intraocular pressure (IOP) as well as the outer appearance of the anterior segment were evaluated. The mean follow-up period was 13 months. RESULTS: The IOP at the last visit was (21.35 +/-2.52) mmHg, which was significantly lower than that before the surgery (39.75 +/-6.27) mmHg, P=0.000]. Atrophy of the ciliary processes was observed 1-3 months after the surgery. CONCLUSION: Pars plana vitrectomy combined with laser coagulation of ciliary processes reduces the IOP in patients with aphakic glaucoma effectively.