青光眼阀植入联合广泛视网膜光凝治疗新生血管性青光眼

目的探讨青光眼阀植入联合广泛视网膜光凝治疗新生血管性青光跟的疗效。方法回顾性分析了16例（16眼）新生血管性青光眼接受青光眼阀植入及广泛视网膜光凝治疗的效果，其中6眼同时行晶状体摘出，4眼同时行晶状体摘出、玻璃体切除。术后随访8～24个月，分析术前与术后的眼压、视力、虹膜表面新生血管及术后并发症。结果术前平均眼压：（45．90±7．84）mmHg（31—67mmHg）。手术后平均眼压：1周为（14．15±3．35）mmHg，2周为（16．30±4．20）mmHg，4周为（17．85±3．15）mmHg，12周为（15．60±2．75）mmHg，末次复诊眼压（18．50±3．75）mmHg。术后末次复诊视力提高11眼，视力不变5眼，无视力下降或丧失者。术后并发症主要有：前房积血3眼，前房形成迟缓及低眼压6眼，引流管堵塞1眼，脉络膜部分脱离1眼。16眼虹膜新生血管全部或部分消退，临床症状缓解。结论青光眼阀植入联合广泛视网膜光凝术治疗新生血管性青光眼既能及时降低眼压，又能拯救或提高视力，是治疗新生血管性青光眼的一种安全而有效的方法。

Effect of glaucoma valve combined with pan retinal photocoagulation in treatment of neovascular glaucoma.

Objective To investigate the therapeutic effect of glaucoma valve combined with retinal photocoagulation in treatment of neovascular glaucoma. Methods Sixteen cases （ sixteen eyes） with neovascular glaucoma were underwent the implantation of glaucoma valve combined with panretinal photocoagulation. In them, six eyes combined with lentectomy, four eyes combined with lentectomy and vitretomy. The followup duration was 8 - 24 months. The visual acuity, intraocular pressure, neovasularization of the iris and complications were observed. Results The visual acuity of preoperation is light perception - 0. 2. The average intraocular pressure of preoperation is 45.90 ± 7.84 mmHg （ 31 - 67 mmHg）. The average intraocular pressure of postoperation is 14.15 ± 3.35 mmHg after one week, 16. 30±4.20 mmHg after 2 weeks, 17.85±3.15 mmHg after 4 weeks, 15.60±2.75mmHg after 12 weeks, 18.50 ± 3.75mmHg in the uhimated cheek- up. In the uhimated check- up of postoperation, visual acuity of 11 cases were improved, 5 cases had no change, No case was decreased and impairmented. The important complications such as hyphema is 3 eyes, shallow anterior chamber is 6 eyes, tube occlusion is 1 eye, detachment of choroid is 1 eye. The new vessels of the iris were disappear in 16 eyes. Clinical symptoms was relieved. Conclusions Glaucoma valve combined with panretinal photocoagulation in treatment of neovascular glaucoma can not only decreased intraocular pressur timely but also increased visual acuity. It is a safe and effective approach to those patients with neovascular glaucoma.