基层医院开展新生血管性青光眼手术疗效观察

目的:探讨基层医院对中晚期新生血管性青光眼(neovascular glaucoma,NVG)手术术式的选择和疗效观察。方法:选取20例21眼中晚期NVG患者,其中7例7眼行睫状体冷凝联合小梁切除术,11例12眼行全视视网膜联合睫状体冷凝术,2例2眼行睫状体冷凝联合涡静脉附近巩膜板层切除术。结果:术后所有患者疼痛症状明显好转,术后3mo眼压<24mmHg者19眼,2眼控制不稳定,最高时达28mmHg。视力5眼提高,14眼无变化,2眼眼球萎缩。所有患者虹膜新生血管全部消退。结论:在没有很好医疗条件的基层医院或患者经济条件不好的情况下,简易的手术方法同样可以解决患者的痛苦,挽救患者的眼球和有用视力,易于被患者接受。

Effectiveness observation of carrying out neovascular glaucoma operation in primary hospitals

AIM:To investigate the operation mode selection and curative effect on the mid-term and late period of neovascular glaucoma(NVG)in primary hospitals.

METHODS: Totally 20 patients(21 eyes)of mid-term and later NVG were included,7 patients(7 eyes)were treated with cyclocryotherapy combined with trabeculectomy; 11 patients(12 eyes)were treated with panretinal cryotherapy combined with cyclocryotherapy; 2 patients(2 eyes)were treated with cyclocryotherapy combined with vortex veins near sclera lamellar resection.

RESULTS: All the patients pain symptoms were improved significantly, 19 eyes with intraocular pressure controlled under 24mmHg 3 months postoperatively, 2 eyes with intraocular pressure instability: the highest reached 28mmHg. Visual acuity was improved in 5 eyes, no change in 14 eyes, 2 eyeballs atrophy. Iris neovascularization disappeared completely in 21 eyes.

CONCLUSION: In case of the absence of good medical condition in primary hospitals or poor economic condition, the simple operation methods can also alleviate the patient's suffering, save the patient's eyeball and useful vision, and it is easy to be accepted by patients too.