经巩膜睫状体光凝术治疗新生血管性青光眼的疗效分析

目的 探讨新生血管性青光眼经巩膜睫状体光凝术治疗(TSCPC)的临床疗效.方法 收集2007年1月至2007年10月于我院眼科门诊就诊的新生血管性青光眼36例(36只眼),经TSCPC治疗.结果 术后第1天平均眼压61.5 mm Hg,1周48.5 mm Hg,3周为45.6 mm Hg,6周36.6 mm Hg,3个月33.2 mm Hg,6个月25.5mm Hg.结论 TSCPC操作相对简单,损伤小,具有重复性,TSCPC已成为新生血管性青光眼以及其他难治性青光眼治疗的首选方法.     

半导体激光经巩膜睫状体光凝术治疗难治性青光眼

目的：评价半导体激光经巩膜睫状体光凝术治疗难治性青光眼的临床疗效和安全性。
　　方法：回顾性分析2012－03／2013－03到我院眼科就诊33例33眼难治性青光眼患者临床资料,所有患者均行半导体激光经巩膜睫状体光凝术,激光能量1000～3000 mW,时间2000～3000ms,击射范围270°～360°,击射点20～40点。随访观察并记录患者临床症状、视力、眼压、眼前节及并发症,随访时间为6 mo。
　　结果：最后随访时32例（97％）的患者眼部症状明显缓解或消失;术前平均眼压为50．26±9．37mmHg,最后随访6mo时平均眼压下降为18．38±8．73mmHg,治疗前后眼压具有统计学意义（P＜0．05）。2例（6％）术后3mo时眼压再次升高,给予再次激光治疗,术后并发症为前房炎症反应9例（27％）,前房出血5例（15％）,结膜下出血2例（6％）,结膜充血水肿12例（36％）,眼球萎缩1例（3％）。结论：半导体激光经巩膜睫状体光凝术治疗难治性青光眼是一种简便、降压显著、痛苦小、安全有效的方法。     

经巩膜睫状体光凝术治疗难治性青光眼预后及影响因素

目的分析经巩膜睫状体光凝术治疗难治性青光眼短期预后情况以及影响因素。方法回顾性病例研究。收集2018年1月至2021年12月安徽医科大学第二附属医院的难治性青光眼90例(90只眼)。分别收集术前及术后1 d、1周、1个月、3个月、6个月患者检查情况,记录视力、眼压、降眼压药物和任何并发症,并根据患者资料对影响经巩膜睫状体光凝术治疗难治性青光眼早期预后的相关因素进行初步筛选,采用多因素Logistic回归模型分析其影响因素。结果患者术前、术后1 d、1周、1个月、3个月、6个月平均眼压分别为(43.9±12.0)、(25.57±8.5)、(23.5±7.5)、(22.3±8.1)、(23.2±8.4)、(24.2±9.1)mmHg;重复测量方差分析结果显示不同时间点测量的眼压与术前相比差异均有统计学意义(F=76.031,均P<0.01)。随着时间延长,患者手术成功率逐渐减少,研究中术后6个月总体累积成功概率为67.7%。多因素回归分析结果显示:术前眼压和术后再次治疗是经巩膜睫状体光凝术治疗难治性青光眼短期预后独立保护因素(P<0.05);性别是其非独立影响因素(均P>0.05)。结论经巩膜睫状体光凝术是治疗难治性青光眼有效的手术方式,不良反应较少,术前眼压和术后再次治疗影响患者手术成功率。     

应用半导体激光经巩膜睫状体光凝术治疗青光眼

抗青光眼手术的主要目的是降低眼内压以达到缓解症状和消除疼痛.其方法大致为两类,一类是增加房水排出量的手术,如周边虹膜切除术,各种滤过性手术,外路小梁切开术等;另一类是减少睫状体分泌房水量的手术,如睫状体冷冻术,睫状体高强度聚焦超声术等.     

半导体二极管激光经巩膜睫状体光凝术治疗难治性青光眼的临床疗效分析

目的　回顾性分析半导体二极管激光经巩膜睫状体光凝术（semiconductor diode laser transscleral photocoagulation,TSCPC）治疗难治性青光眼的有效性和安全性。方法　收集2015年1月至2017年4月在江苏省人民医院眼科接受TSCPC治疗的难治性青光眼患者;记录并分析患者的一般资料,包括病因、激光能量、视力、术前及术后不同时间点的眼压、用药种类和炎性反应、手术成功率以及并发症等。结果　本研究共纳入患者54例（54眼）,随访时间为（13.7±4.2）个月,使用的激光能量为（112.7±31.0）J。TSCPC术后1 a手术完全成功率为72.2%,相对成功率为85.2%;眼压由术前的（42.4±10.0）mmHg（1 kPa=7.5 mmHg）降至术后的（13.3±5.8）mmHg,用药种类由术前的（2.68±0.83）种减少至术后的（0.15±0.43）种;术后1 d、1周、1个月、3个月、6个月、9个月、12个月的眼压和用药种类与术前相比差异均有统计学意义（均为P<0.05）。TSCPC对新生血管性青光眼的降眼压效果优于原发性闭角型青光眼,差异有统计学意义（P=0.04）。5眼（9.3%）发生了并发症,其中持续的炎性反应2眼（3.7%）。结论　TSCPC能够安全有效地降低难治性青光眼患者的眼压,并且减少用药种类。     

半导体激光经巩膜睫状体光凝治疗难治性青光眼

目的     

基于爆破音的两种经巩膜睫状体光凝方案治疗难治性青光眼的疗效比较

目的 探讨根据爆破音调节经巩膜二极管激光睫状体光凝能量方案治疗难治性青光眼的疗效。设计 回顾性比较性病例系列。研究对象 难治性青光眼患者62例（62眼）。方法 将患者随机分为爆破音调节能量组（调节组）30例（30眼）,爆破音固定能量组（固定组）32例（32眼）。调节组在经巩膜二极管激光睫状体光凝术术中根据爆破音出现的频率不断调节能量。固定组以首次出现爆破音的能量完成手术。术后随访3个月。主要指标 激光总平均能量、爆破音数量、眼压、视力、用药数量、术后并发症。结果 术前及术后3个月调节组平均眼压分别为（46.1±10.7）mmHg和（15.8±6.9）mmHg;固定组分别为（44.9±12.3）mmHg和（16.7±8.2）mmHg。不使用降眼压药物眼压控制在 21 mmHg以下者,调节组占80.0%,固定组占65.6%（χ2=5.643,P=0.018）。爆破音数量与眼压下降幅度呈中度正相关（调节组r=0.517,P=0.001;固定组r=0.572,P=0.001）。调节组术后1例视力下降;固定组术后2例视力下降,1例持续性低眼压。结论 爆破音调节能量的经巩膜睫状体光凝方案较爆破音固定能量方案对难治性青光眼的的疗效更好。（眼科, 2020, 29： 147-151）     

经巩膜睫状体光凝术治疗难治性青光眼的效果

目的:评价经巩膜睫状体光凝术(TCP)治疗难治性青光眼的效果。方法:回顾性研究。对北京爱尔英智眼科医院2017年7月至2018年12月行TCP治疗的难治性青光眼73例(81只眼)的临床资料进行分析。观察手术前后眼压、降眼压药物使用种类、术中光凝情况和并发症的发生。术后随访6个月。结果:术前眼压(35.0±8.8)mmH...     

难治性青光眼半导体激光经巩膜睫状体光凝术

目的　评价半导体激光经巩膜睫状体光凝术治疗难治性青光眼的效果和安全性。方法　 68例 (69眼 )接受治疗 ,术后随访 6～ 17月。分析末次治疗后第 6月的眼压、视力和眼部症状。结果　无光感组 (3 6眼 ) :光凝术前眼压 (61.16± 12 .44 )mmHg(1mmHg =0 .13 3kPa) ,末次光凝术后第 6月后 3 3眼眼压 (2 9.67± 6.79)mmHg。 3眼眼球萎缩 ,12眼需 2次或多次治疗。光感及光感以上组 (3 3眼 ) :光凝术前眼压 (5 1.72± 13 .85 )mmHg ,末次光凝术后第 6月眼压 (2 1.42± 8.2 2 )mmHg。其中 11眼需要 2次或 3次光凝术 ,4眼 3次光凝术后眼压仍高于 2 1mmHg。结论　半导体激光经巩膜睫状体光凝术是一种简单、安全、有效的治疗难治性青光眼的方法 ,但常需要重复治疗。     

经巩膜睫状体光凝治疗难治性青光眼的临床观察

目的:评价半导体激光经巩膜睫状体光凝术治疗难治性青光眼的效果。方法:回顾性分析55例56眼难治性青光眼的临床资料,均行睫状体光凝,术后随访观察并记录眼压、视力、眼部自觉症状以及并发症,随访时间3mo以上。结果:术前平均眼压53.5±18.7mmHg,末次随访平均眼压为19.4±9.6mmHg,术后眼压与术前眼压相比,差别具有统计学意义(P<0.01)。术后44眼视力无变化,2眼视力提高,10眼视力下降;眼痛均消失或缓解;并发症少,主要有葡萄膜炎、前房出血等。结论:睫状体光凝能有效降低难治性青光眼患者的眼压,且并发症少。     

经巩膜睫状体光凝术治疗睫状环阻滞性青光眼临床观察

目的:探讨经巩膜睫状体光凝术治疗睫状环阻滞性青光眼的疗效、安全性、术后并发症。方法:睫状环阻滞性青光眼7例7眼,应用可耐受最大剂量降眼压药物治疗后眼压仍在30mmHg左右,行810nm激光经巩膜睫状体光凝。结果:患者7例治疗前平均眼压33.63±4.50mmHg,光凝后1wk平均眼压15.88±3.21,两者比较,差异有显著意义(P<0.05);治疗前平均视力0.16±0.11,光凝后1wk平均视力0.42±0.20,两者比较,差异有显著意义(P<0.05),所有患者前房均在36h内逐渐恢复,1例患者术后前房稍许出血,治疗后好转。结论:经巩膜睫状体光凝术是治疗睫状环阻滞性青光眼的安全、有效方法。     

Long-term follow-up after transscleral diode laser photocoagulation in refractory glaucoma

BACKGROUND AND OBJECTIVE: Patients affected by glaucoma refractory to medical or surgical treatment are difficult to treat. The aim of this study was to evaluate the long-term effect of contact transscleral diode laser cyclophotocoagulation (DLPC) on intraocular pressure (IOP) and on visual acuity of these patients. PATIENTS AND METHODS: One hundred and twenty eyes of 107 patients suffering from refractory glaucoma and treated with DLPC were followed at the Eye Clinic of Verona University for an average of 26 +/- 8 months. Mean age was 57 +/- 26 years. IOP, visual acuity, and ocular complications were analyzed. RESULTS: A total of 207 treatments were given. More than one treatment was given in 55 eyes (45.8%). Mean pretreatment IOP was 30.4 +/- 3.1 mm Hg. At the last follow-up, mean IOP was 20.3 +/- 1.8 mm Hg. Mean total medications were reduced from 4.5 +/- 0.5 to 2.3 +/- 0.3. No serious complications occurred in the 207 treatments. Visual acuity remained stable in 66 eyes (55%), improved in 25 eyes (20.8%), and decreased in 29 eyes (24.2%). CONCLUSIONS: DLPC was effective in lowering IOP in eyes with refractory glaucoma. It also served to reduce the number of antiglaucoma medications, thus improving both the quality of life of the patients and their compliance to therapy. This procedure is relatively safe, very fast and easy to learn. However, careful attention is required to determine the exact position of the ciliary body in malformative glaucoma. Multiple treatments may be required to control IOP.     

Effect of diode laser contact transscleral pars plana photocoagulation on intraocular pressure in glaucoma

Purpose : To evaluate the efficacy of diode laser contact transscleral pars plana photocoagulation (CTPPP) for intraocular pressure (IOP) control in glaucoma and its clinical application. Method : A prospective, non‐randomized hospital‐based pilot study was conducted. Fourteen patients with poor visual acuity (VA worse than 6/60) and medically uncontrolled, refractory glaucoma were recruited, and CTPPP was performed after informed consent. Results : Mean preoperative IOP was 41.0 mmHg (SD 12.6, range 27?70, n = 14). At 1 week postoperatively, IOP was reduced in 12 of 14 (86%) patients to a mean of 28.6 mmHg (SD 15.8, range 3?55, n = 14). This represented a mean decrease of 12.4 mmHg. Mean IOP was 34.0 mmHg (SD 17.4, range 5?71, n = 14) and 31.6 mmHg (SD 13.4, range 5?22, n = 12) at 4 and 12 weeks, respectively. The IOP reduction was significant at 1 week (P = 0.001, paired t‐test) and at 12 weeks (P = 0.04, paired t‐test). The two patients with preoperative pain reported abolition of pain after the procedure. Seven of 13 patients on preoperative antiglaucoma eye drops did not require eye drops postoperatively. Conclusions : Diode laser CTPPP was found to significantly reduce IOP in the majority of patients at 1 week postoperatively, with less but still significant effect at 12 weeks. Its potential application as a procedure for short‐term IOP reduction in medically uncontrolled glaucoma requiring filtering surgery needs to be further investigated.     

半导体激光治疗重症青光眼--睫状体光凝和睫状体冷冻的对比研究

６０例（６０只眼）重症青光眼患者，随机分成半导体激光经巩膜睫状体光凝组和睫状体冷冻组。半导体激光功率１．５～２．０Ｗ、脉冲时间２ｓ、治疗范围２７０°，发射１２～２０个激光点。所有病例均完成３个月的随访观察，结果与冷冻组比较，光凝组治疗成功率为７３．３％，疼痛解除率为９６．７％，Ｐ＞０．０５；光凝组治疗后１天及１周的眼压分别为２２．１０±９．３４ｍｍＨｇ和１８．１３±６．４０ｍｍＨｇ，Ｐ＜０．０１；末次随访时光凝组眼压２０．５４±７．９６ｍｍＨｇ，Ｐ＞０．０５。光凝组早期并发症少，Ｐ＜０．０１。半导体激光经巩膜睫状体光凝与传统的睫状体冷冻比较，具有简便、安全、降压快、副作用小、疗效可靠等优点，是治疗难治性青光眼的有效手段之一。     

半导体激光透巩膜光凝睫状体治疗难治性青光眼

本文评价了非接触性半导体激光透巩膜睫状体光凝治疗青光的疗效。15名患者16只眼,新生血管性青光眼3例,慢闭8例,慢性开角型4例,外伤后继发性青光眼1例。表面麻醉下于角巩缘后1mm光凝360°(,均匀分布光凝点,点数25—110,光斑直径200μm,功率0.75-1W,脉宽3-5s,离焦1.5mm。平均随访时间3月,平均眼压从术前27.1±7.5mmHg下降至19.5±8.4mmHg,平均下降7.6±4.6mmHg。术后眼压下降值与光凝况能量相关,术中12例(75%)光凝颞上象限时有轻至中度疼痛。术后并发症有结膜充血7例(44%),均于1周内消退。1例(6%)术后天疼痛明显,1周后缓解。以上结果表明应表表面麻醉非接触式DCCP是一种简便、易行,有一定疗效的治疗青光眼的方法。     

Diode laser transscleral cyclophotocoagulation for refractory glaucoma

PURPOSE: To evaluate the efficacy of contact diode laser transscleral cyclophotocoagulation using different treatment parameters. METHODS: All eyes undergoing contact diode laser transscleral cyclophotocoagulation between April 1991 and September 1997 at our two institutions were enrolled. Success was defined as an intraocular pressure less than or equal to 22 mm Hg or absence of pain for poorly sighted and blind eyes. RESULTS: Two hundred six eyes of 204 patients (Salzburg, 117 eyes; New York, 89 eyes) were enrolled. Mean patient age was 65.8 +/- 18.7 years (range, 4-96 years). Mean follow-up was 9.2 +/- 11.2 months (range, 3-56 months). Mean preoperative and postoperative IOPs were 42.1 +/- 11.0 mm Hg (range, 24-76 mm Hg) and 17.3 +/- 10.9 mm Hg (P < 0.001) and 20.3 +/- 13.2 mm Hg (P < 0.001) at 12 and 24 months, respectively. The number of laser applications (mean, 18.6 +/- 4.2; range, 10-40) and maximal laser power (mean, 2,352 +/- 408.5 mW; range, 1,500-3,000) were not associated with a lower postoperative IOP. An IOP less than or equal to 22 mm Hg was achieved in 72.7% of eyes at the mean follow-up of 9 months. Thirty-three (16.0%) eyes required at least one retreatment. Phthisis occurred in four (1.9%) eyes. CONCLUSION: Contact diode laser transscleral cyclophotocoagulation is useful in eyes with refractory glaucoma in which the risks of outflow surgery are deemed unacceptable.