CAJ | 학술논문

目的探讨新生血管性青光眼(neovascular glaucoma,NVG)的原发病因和手术治疗方案的选择.方法对NVG患者97例108只眼的病因和手术资料进行分析总结.结果在所有的患者中,视网膜静脉阻塞导致NVG的患者最多,其次为糖尿病视网膜病变;两者之合共67例74只眼,占总例数的69.1%,总眼数的68.5%.其他的病因包括眼缺血综合征5例6只眼,Coat病4例4只眼,慢性色素膜炎3例4只眼,慢性闭角型青光眼3例3只眼,以及一些相对少见的病因.37只眼接受或者补充完成了全视网膜光凝治疗,其中34只眼(91.9%)新生血管完全消退.47只眼接受了全周边视网膜冷凝治疗,其中38只眼(80.9%)的新生血管完全消退.在接受改良式小梁切除、术前或术后全视网膜光凝治疗的26只眼中,21只眼(80.8%)的眼压控制良好.在接受玻璃体切除+全视网膜光凝+小梁切除术的9只眼中,8只眼(88.9%)眼压控制良好.4只眼接受青光眼阀植入手术,在平均5.5月随访期内眼压控制良好.39只眼先后接受52次半周睫状体冷冻术,其中30只眼(76.9%)眼压控制良好.结论 NVG的病因复杂多样,手术治疗应该根据不同的临床特点制定个体化的治疗方案.
목적 탐토신생혈관성청광안(neovascular glaucoma,NVG)적원발병인화수술치료방안적선택.방법 대NVG환자97례108지안적병인화수술자료진행분석총결.결과 재소유적환자중,시망막정맥조새도치NVG적환자최다,기차위당뇨병시망막병변;량자지합공67례74지안,점총례수적69.1%,총안수적68.5%.기타적병인포괄안결혈종합정5례6지안,Coat병4례4지안,만성색소막염3례4지안,만성폐각형청광안3례3지안,이급일사상대소견적병인.37지안접수혹자보충완성료전시망막광응치료,기중34지안(91.9%)신생혈관완전소퇴.47지안접수료전주변시망막냉응치료,기중38지안(80.9%)적신생혈관완전소퇴.재접수개량식소량절제、술전혹술후전시망막광응치료적26지안중,21지안(80.8%)적안압공제량호.재접수파리체절제+전시망막광응+소량절제술적9지안중,8지안(88.9%)안압공제량호.4지안접수청광안벌식입수술,재평균5.5월수방기내안압공제량호.39지안선후접수52차반주첩상체냉동술,기중30지안(76.9%)안압공제량호.결론 NVG적병인복잡다양,수술치료응해근거불동적림상특점제정개체화적치료방안.
Objective To investigate the etiology and surgical treatment of neovascular glaucoma(NVG).Methods The etiological and surgical data of 108 eyes of 97 NVG patients were analyzed and summarized. Results Of all the causes,retinal vein occlusion was the principal cause,followed by diabetic retinopathy, and their sum were 74 eyes of 67 patients, 69.1% of all patients and 68.5% of all NVG eyes. The other causes included ocular ischemia syndrome ( 6 eyes of 5 patients ), Coat's disease ( 4 eyes of 4 patients),chronic uveitis ( 4 eyes of 3 patients ), chronic angle-closure glaucoma ( 3 eyes of 3 patients ), and some relatively unusual causes. Of 37 eyes performed panretinal photocoagulation, the new vessels of 34 eyes (91.9%) were disappear, of 47 eyes performed pan-peripheral retinal cryotheraphy, the new vessels of 38 eyes(80.9%) were disappear, of 26 eyes performed improved trabeculectomy with preoperative or postoperative panretinal photocoagulation, the intraocular pressures (IOP) of 21 eyes ( 80.8%)were fully controlled. Of 9 eyes performed vitrectomy and panretinal photocoagulation and trabeculectomy, the IOP of 8 eyes ( 88.9%)were fully controlled. All 4 eyes performed glaucoma drainage implant placement appeared fully controlled IOP during the average follow-up time of 5.5 months. Of 39 eyes performed 52 semicircular ciliary body cryotheraphies early or late, the IOP of 30 eyes (76.9%) were fully controlled. Conclusions The causes of NVG are complicated and various, and the individual operation should be performed according to various clinical characteristic.