高聚焦超声睫状体成形术和睫状体冷冻术治疗难治性青光眼的疗效比较

目的:比较高聚焦超声睫状体成形术(UCP)和睫状体冷冻术治疗难治性青光眼的疗效。方法:回顾性研究。收集2017-01/2020-12本院收治的难治性青光眼患者45例81眼,依据患者治疗方法不同分为睫状体冷冻术组22例40眼,高聚焦超声睫状体成形术组23例41眼。观察两组患者术前,术后1d,1wk,1、3mo眼压变化情况,采用疼痛数字等级评定量表(NRS)评估眼球疼痛程度,比较两组患者手术效果和并发症发生情况。结果:高聚焦超声睫状体成形术组手术总有效率明显高于睫状体冷冻术组(P<0.05),两组患者术后1d,1wk,1、3mo眼压和眼球疼痛程度均低于术前(均P<0.05),两组间患者术后各时间点眼压和眼球疼痛程度比较均有差异(均P<0.05)。高聚焦超声睫状体成形术组患者结膜充血、角膜水肿、前房炎性渗出、反应性高眼压和前房积血并发症发生率低于睫状体冷冻术组(P<0.05)。结论:高聚焦超声睫状体成形术治疗难治性青光眼疗效明确,在降低患者眼压、减少眼球疼痛和并发症发生方面较睫状体冷冻术有明显优势。

Comparison of the therapeutic effects of high-intensity focused ultrasound cycloplasty and cyclocryotherapy on refractory glaucoma

AIM: To compare the therapeutic effects of high-intensity focused ultrasound cycloplasty(UCP)and cyclocryotherapy on refractory glaucoma.

METHODS:This retrospective study included 45 patients(81 eyes)with refractory glaucoma admitted to the hospital between January 2017 and December 2020. According to the treatment method, patients enrolled were divided into cyclocryotherapy group(22 patients, 40 eyes)and high-intensity UCP group(23 patients, 41 eyes). Changes in intraocular pressure at 1d, 1wk, 1 and 3mo after operation were compared between the two groups. The Numerical Rating Scale(NRS)was used to evaluate eyeball pain. Surgical results and complications in the two groups were compared.

RESULTS:The total effective rate of operation in the high-intensity UCP group was significantly higher than that in the control group(P<0.05). Generalized estimation equation analysis showed that there were statistically significant differences in intraocular pressure and eyeball pain between the two groups before and after operation(all P<0.05). There were statistically significant differences in intraocular pressure and eyeball pain between the two groups at different time points after operation(all P<0.05). The incidence rates of complications such as conjunctival hyperemia, corneal edema, anterior chamber inflammatory exudation, reactive intraocular hypertension and hyphema in the high-intensity UCP group were significantly lower than those in the cyclocryotherapy group(P<0.05).

CONCLUSION: High-intensity UCP is effective in the treatment of refractory glaucoma, with obvious advantages in reducing intraocular pressure, eyeball pain and complications as compared with cyclocryotherapy.