显微镜直视下睫状体光凝治疗玻璃体切除术后难治性青光眼

摘要

目的：观察显微直视下睫状体光凝治疗玻璃体切除术后难治性青光眼的疗效。方法选择近1年来我院诊治的10例玻璃体切除术后难治性青光眼患者，获得知情同意后使用23 G玻切套管行眼内光凝，在显微镜下直视配合巩膜顶压光凝1／3～1／2周睫状突，术后3d、1周、1个月及3个月复查视力、眼压，观察眼内反应等情况。结果术后所有患者眼压较术前明显下降，术前平均﹙37．75±6．70﹚mmHg（30．0～50．0 mmHg），术后3个月时平均﹙16．21±6．86﹚mmHg（9．5～28．0 mmHg），差异具有统计学意义（ P ＜0．01，配对t检验），术前术后视力比较无统计学差异，术中术后所有患者均未出现明显并发症。结论眼内激光直视配合巩膜顶压下行睫状体光凝是治疗玻璃体切除术后难治性青光眼的一种安全有效的手段。%Objective To evaluate the effect of cyclophotocoagulation under microscopic direct vision on intraocu-lar pressure ( IOP) in eyes with refractory glaucoma after vitrectomy.Methods Author reviewed clinical records of 10 ca-ses of medically uncontrolled glaucoma after vitrectomy.After informed consent, they were all performed cyclophotocoagula-tion under microscopic direct vision and scleral pression using 23 gauge intraocular photocoagulation.1/3~1/2 cycle of ciliary processes were coagulated.All the patients were followed up for visual acuity, IOP and intraocular reaction 1~3 days, 1 week, 1 month and 3 months after surgries.Results The IOP was found to have decreased significantly from a pre-treatment value of 37.75 ±6.70 mmHg(rang 30.0~50.0mmHg) to 16.21 ±6.86 mmHg(9.5~28.0 mmHg) at 3 months of follow up ( P <0.01,Paired t-test).There was no significant difference in visual acuity before and after operation.No obvious complications occurred during or after operations.Conclusion Cyclophotocoagulation under microscopic direct vi-sion and scleral pression is safe and effective for the patients with refractory glaucoma after vitrectomy.