新生血管性青光眼手术治疗分析

目的比较不同手术方法治疗新生血管性青光眼（NVC）的疗效。方法对30例30只眼NVG的不同手术方式进行回顾性分析,其中行单纯睫状体冷凝术10例,周边视网膜冷凝联合睫状体冷凝术13例,小梁切除＋睫状体冷凝＋次全视网膜冷凝术7例。比较患者手术前后主观眼痛症状、眼压及视力变化情况。随访10-28个月。结果患者出院时的平均眼压：A组为（28.08±5.11）mmHg,B组为（20.60±6.28）mmHg,C组为（19.43±7.07）mmHg。随访期间,术后A组4例眼压正常,手术成功率40%,B组10例眼压正常,手术成功率76.9%,C组4例眼压正常,手术成功率57.1%。结论对于不同病情的NVG患者,可以采用不同的手术方式进行治疗。传统睫状体冷凝术在缓解疼痛及降低眼压方面作用明显,但疗效欠稳定,术后并发症多。小梁切除＋睫状体冷凝＋次全视网膜冷凝术手术要求较高,容易引起新生血管出血。对于晚期病例合并屈光间质浑浊的新生血管性青光眼,选择次全视网膜冷凝联合睫状体冷凝治疗是一种较理想的方法。

Effects of different operation on neovascular glaucoma

Objective To evaluate the clinical effects of different surgical management on neovascular glaucoma （NVG）. Methods 30 eyes in 30 cases with neovascular glaucoma received different surgical manage- ments were analyzed retrospectively. All eases were dived into three groups： Group A： 10 eyes treatd with cyclo- cryotherapy, Group B： 13 eyes treated with the retina cryoautery combined with ciliary body cryoantery, and Group C ： 7 eyes trated with combination of trabeculectomy and cryothe rapy of peripheral retina and ciliary. Pre and post- operative intraocular pressures （lOPs） were comparatively observed in all cases. The changes in visual acuity were evaluated. Results The intraocular pressure （IOP） were controlled to （ 28.08 ± 5.11 ） mmHg in 4 cases, （20. 60 ± 6.28） mmHg in 10 eyes and （ 19.43 ± 7.07） mmHg in 4 cases, with the surgery successful rate 40%, 76.9% and 57.1% in group A, B and C, respectively. Conclusions Various surgery techniques for neovascular glaucoma should be chosen depending on different condition.