联合手术治疗新生血管性青光眼疗效比较

目的 比较两组治疗新生血管性青光眼方法的效果.方法 前瞻性随机对照研究.41例(41只眼)新生血管性青光眼随机分2组.A组(20只眼)行手术区域虹膜、房角新生血管光凝及小梁切除联合前视网膜冷凝术.B组(21只眼)行睫状体冷凝术联合前部视网膜冷凝术.观察1周内眼压及眼内情况;随访1年眼压及并发症情况.结果 术后1周A组眼压明显低于B组,差异有统计学意义(t=7.12P<0.01);A组疼痛消失明显,差异有统计学意义(χ2=7.15 P<0.01).术后1年A组眼压有90%(18/20)正常,B组有49%(10/21)正常,差异有统计学意义(t=2.37 P<0.05),两组病例中虹膜新生血管均有减退,A组优于B组,差异有统计学意义(χ2=5.53 P<0.05).结论 手术区域虹膜、房角新生血管光凝及小梁切除联合前视网膜冷凝术效疗更优越.

Clinical Comparative Study about the Combined Surgical Treatment of Neovascular Glaucoma

Objective To compare the treatment effect of two different strategies of containment neo-vascularization by solving retinal hypoxia with reducing aqueous humor flow or finding another filtration channel due to obstruction of anterior chamber angle neovascularization, and to evaluate which methods had more advantage. Methods A randomized control trial study.Forty-one patients (41 eyes) with neovascular glaucoma were randomly divided into two groups, group A (20 eyes) was treated with iris and chamber angle neovascularization phtocoagulation and trabeculectomy combined with anterior retinal ciyotherapy (ARC) while group B (20 eyes) received cyclocryosurgery combined with anterior retinal cryotherapy (ARC) .The intraocular pressure (IOP) and conditions in the eye in one week were observed.Follow-up status of intraocular pressure and complication was one year.Results Intraocular pressure of group A was remarkable lower than group B one week after the operation, there was statistical significant difference (t=7.12, P<0.01) between two groups. Ophthalmalgia of group A was significant relieved, showing significant difference (χ2=7.15, P<0.01 ).In one year of postoperation, intraocular pressure of group A was controlled in normal range accounted for 90% (18/20) while group B occupied 49% (10/21), the difference was statistically significant (t=2.73, P<0.05). Iris neovascularization (INV) of two groups both decreased, but group A was better than group B, thus they had statistical differences (χ2=5.53, P<0.05).Conclusions Ms and chamber angle neovascularization phtocoagulation and trabeculectomy combined with anterior retinal cryotherapy (ARC) has more advantage in treatment of neovascular glaucoma.