内窥镜下激光睫状体光凝术联合玻璃体切割术治疗糖尿病新生血管性青光眼的临床疗效

目的　探讨内窥镜下激光睫状体光凝术联合玻璃体切割术治疗糖尿病新生血管性青光眼的临床疗效。方法　选取２４例（２４眼）糖尿病新生血管性青光眼患者，行内窥镜下激光睫状体光凝术联合玻璃体切割术，术后至少随访６个月。观测指标包括手术前后患者视力、眼压变化、新生血管消退程度和术后并发症情况。结果　术后视力提高１４眼，不变８眼，降低２眼。术后第１天眼压为（２９．４±１０．８）ｍｍＨｇ（１ｋＰａ＝７．５ｍｍＨｇ），１个月时为（２１．０±１１．９）ｍｍＨｇ，最终随访时为（２０．１±１０．８）ｍｍ-Ｈｇ，与术前（４６．６±７．３）ｍｍＨｇ比较，差异均有统计学意义（均为Ｐ＜０．０５）。术后新生血管完全消失１０眼，部分消失残留少量无功能血管者１２眼，未见明显改善者２眼。术后第１天８例患者发生颜面部浮肿；术后发生球结膜混合充血９眼、角膜水肿４眼、一过性高眼压４眼、复发性玻璃体出血１眼（后行玻璃体腔灌洗术后病情稳定）。结论　内窥镜下激光睫状体光凝术联合玻璃体切割术治疗糖尿病新生血管性青光眼短期内临床效果显著，并发症少，患者痛苦少，是一种相对有效、安全的手术方法。

Endoscopic cyclophotocoagulation combined with vitrectomy in treatment of diabetic neovascular glaucoma

Objective To analyze the clinical effects and safety of endoscopic cyclophotocoagulation combined with vitrectomy on diabetic neovascular glaucoma retrospectively. Methods Twenty-four patients ( 24 eyes) with diabetic neovascular glaucoma were chosen. All the patients were performed endoscopic cyclophotocoagulation ( ECP) .according to the preoperative intraocular pressure ( IOP) and new vessels. IOP.visual acuity,new vessels fading degree and complications were observed before and after surgery. A1l patients were received at least six months follow-up after the treatment. Results After treatment , the visual acuity of the patients was improved in 14 eyes , stabled in 8 eyes ,reduced in 2 eyes. The average IOP before treatment and at I day ,1 month .6 months after treatment were ( 46. 6 +7. 33) mmHg ( I kPa = 7. 5 mmHg) , ( 29. 4 + 10. 84 ) mmHg , ( 21. 0 + 11. 9 ) mmHg and ( 20. I + 10. 8 ) mmHg , respectively. After operation,the new vessels were disappeared in 10 eyes ,12 eyes with a small amount of no functional residual vessels ,2 eyes with no improvement. Postoperative complications were facial edema ( 8 cases) . nuxed conjunctival congestion ( 9 cases) . corneal edema (4 cases) .transient high IOP (4 cases) and recurrent vitreous hemorrhage ( I case). Conclusion Endoscopic cyclophotocoagulation combined with vitrectomy for diabetic neovascular glaucoma has obvious clinical effect during a short time follow up. It is a relatively effective and safe surgical method with few complications and less pain.