CAJ | 학술논문

目的：对需行玻璃体手术且并发新生血管性青光眼的患者进行眼内睫状突光凝术,观察术后眼压控制效果及手术安全性。 　　方法：回顾12例14眼新生血管性青光眼患者,分别继发于糖尿病性视网膜病变、视网膜脱离术后及眼外伤。本术式主要是在玻璃体切除术后立即采用眼内光凝导管直接对睫状突进行光凝,直到睫状突出现白色萎缩或爆破音为止,曝光时间0.1~0.2ms,能量300~500mW。术后随访6mo,分别于术后1wk；1,6mo观察14只新生血管性青光眼的眼压和并发症情况。 　　结果：本研究发现11眼眼压出现明显下降至正常范围之内。光凝术后1wk平均眼压为16.7±14.4mmHg,1mo为15.7±8.8mmHg,6mo为12.9±4.5mmHg,与治疗前(39.6±10.0mmHg)相比差异具有统计学意义(P<0.01)。随访期间3眼再次出现眼压升高,因其不具备再次玻璃体手术适应证而给予了经巩膜或内窥镜下睫状体突光凝术。随访期间患眼未出现眼内炎及眼球萎缩等并发症。 　　结论：眼内睫状突光凝与玻璃体手术同时进行,可同时处理原发疾病和青光眼。该术式可在直视下准确光凝睫状突,对治疗需要玻璃体切除术的新生血管性青光眼是一种较安全有效的方法。
목적：대수행파리체수술차병발신생혈관성청광안적환자진행안내첩상돌광응술,관찰술후안압공제효과급수술안전성。 　　방법：회고12례14안신생혈관성청광안환자,분별계발우당뇨병성시망막병변、시망막탈리술후급안외상。본술식주요시재파리체절제술후립즉채용안내광응도관직접대첩상돌진행광응,직도첩상돌출현백색위축혹폭파음위지,폭광시간0.1~0.2ms,능량300~500mW。술후수방6mo,분별우술후1wk；1,6mo관찰14지신생혈관성청광안적안압화병발증정황。 　　결과：본연구발현11안안압출현명현하강지정상범위지내。광응술후1wk평균안압위16.7±14.4mmHg,1mo위15.7±8.8mmHg,6mo위12.9±4.5mmHg,여치료전(39.6±10.0mmHg)상비차이구유통계학의의(P<0.01)。수방기간3안재차출현안압승고,인기불구비재차파리체수술괄응증이급여료경공막혹내규경하첩상체돌광응술。수방기간환안미출현안내염급안구위축등병발증。 　　결론：안내첩상돌광응여파리체수술동시진행,가동시처리원발질병화청광안。해술식가재직시하준학광응첩상돌,대치료수요파리체절제술적신생혈관성청광안시일충교안전유효적방법。
AlM: To observe the postoperative intraocular pressure ( lOP) and operation safety in the eyes of the neovascular glaucoma pateints treated by intraocular cyclophotocoagulation which needed vitrectomy at the same time. METHODS: A total of 12 neovascular glaucoma cases ( 14 eyes ) secondary to diabetic retinopathy, retinal detachment surgery and trauma were reviewed in our study. This procedure mainly used intraocular photocoagulation catheter to highlight the ciliary processes until the ciliary became white atrophy or plosion after vitreous surgery treatment. The intraocular photocoagulation catheter was performed at a power of 300-500mW, for a duration of 0. 1-0. 2ms. Postoperative follow-up was at least for 6mo. The observation of 14 postoperative neovascular glaucoma was performed at 1wk, 1, 6mo observing the lOP and complications. RESULTS:lOP of the 11 eyes was significantly declined and controlled in normal. After cyclophotocoagulation, average lOP at 1wk was 16. 7±14. 4mmHg, 15. 7±8. 8mmHg at 1mo and 12. 9±4. 5mmHg at 6mo, which compared with untreatment ( 39. 6 ± 10. 0mmHg ) was statistically significant different (P<0. 01). ln follow up time 3 cases were relapsed which were supplied with transscleral or endoscope cyclophotocoagulation. During the follow-up period no endophthalmitis and complications such as eyeball atrophy were found. CONCLUSlON: The intraocular cyclophotocoagulation and vitrectomy simultaneously can deal with the primary disease and secondary neovascular glaucoma. The operation can be accurately performed under direct cyclophotocoagulation and it is a safe and effective way for neovascular glaucoma which needs vitreous surgery.