睫状体冷冻及经巩膜二极管激光光凝治疗重症青光眼的疗效分析

目的:比较睫状体冷冻及经巩膜二极管激光光凝治疗重症青光眼的效果。方法:收集我院2006-08/2007-10重症青光眼患者72例(72眼),用睫状体冷冻及半导体二极管激光治疗,随机分为两组,睫状体冷冻组36例(36眼),于角巩膜缘后2mm区域360°用液态二氧化碳冷冻机行睫状体冷冻,共6～8点,60～120s/点。睫状体光凝组36例(36眼),于角巩膜缘后1.5mm行全周睫状体光凝,激光点数16～36点,能量1.4～2.0W,脉冲时间0.5～2s。结果:对睫状体冷冻组及睫状体光凝组进行术后观察1,7d;1,3,6mo后分析比较,术后短期内:眼压降低、术后渗出反应及疼痛等指征有显著差异(P<0.05),远期各项比较无显著差异。结论:两组方法对于治疗重症青光眼,控制眼压,缓解疼痛均有显著疗效,睫状体光凝能量确切,操作简便安全,术后眼压下降迅速,对眼睑、结膜及巩膜等影响小,眼球萎缩及光感消失等发生几率低,而睫状体冷冻对于角膜变性、角巩膜葡萄肿及先天性大眼球等激光定位困难且易穿孔者有优势。

Effect of transscleral diode laser cyclophotocoagulation and cyclocryosurgery in treatment of severe glaucoma

AIM:To compare the effect of diode laser transscleral cyclophotocoagulation(DL Tscpc)with cyclocryosurgery for severe glaucoma.METHODS:A total of 72 cases(72 eyes)with severe glaucoma were randomly divided into two groups.Group A(36 eyes)was treated by cyclocryosurgery using liquid carbon dioxide freezer with 6-8 spots and 60-120 seconds of every spot behind 2mm of corneoscleral limbus of all around.Group B(36 eyes)was treated by DL Tscpc with energy power of 1.4-2.0W and laser spots of 16-36 and the pulse time of 0.5-2.0 seconds behind 1.5mm of corneoscleral limbus of all around.Intraocular pressure(IOP),visual acuity,ocular pain symptoms and complic-ations were observed after cyclocryosurgery and DL Tscpc.RESULTS:After 1,7 days,1,3 and 6 months of follo-wed up,the results showed that the short-term IOP bet-ween two groups had significant deviation(P<0.05),but the long-term IOP had no statistical significance(P>0.05).CONCLUSION:These two methods make effect in treatment of severe glaucoma including controlling IOP and relieving pain of eyes.It is concluded that DL TScpc is a simple,safe and effective therapy for eyes with severe glaucoma,but cyclocryosurgery has other fortes in treatment of corneal degeneration,corneoscleral staph-yloma and inborn macrophthalmia.