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目的探讨使用氩激光行虹膜及前房角新生血管漂白术联合小梁切除术和丝裂霉素治疗新生血管性青光眼的疗效。方法对47例(47眼)新生血管性青光眼先用氩激光封闭虹膜表面及前房角新生血管,次日行丝裂霉素联合小梁切除术,观察降眼压效果及其手术并发症。结果1.手术成功41例(87.2%),失败6例(12.8%);2.术后视力提高2行及以上者17例(36.1%),提高1行或不变者26例(55.3%),下降4例(8.6%);3.术后眼压较治疗前有显著意义的降低(P<0.01);4.功能性滤过泡在术后早期均有,6月后有41例(87.23%);5.新生血管在术后早期全部消退,3月后出现4例(8.51%);6.术中及术后早期前房出血分别为8例(17.02%)、5例(10.64%),无其它严重并发症发生。结论氩激光联合小梁切除术可作为治疗新生血管性青光眼的一种有效治疗方法。
Objective To investigate the curative effect of argon laser on iris and anterior chamber angle neovascularization combined with trabeculectomy and mitomycin for neovascular glaucoma. Methods Forty-seven eyes (47 eyes) with neovascular glaucoma were treated with argon laser to close the surface of the iris and the new angle anterior horn angiogenesis. Mitomycin and trabeculectomy were performed the next day. The intraocular pressure reduction and complications were observed. Results 1. Successful operation was performed in 41 cases (87.2%) and failed in 6 cases (12.8%). 2. Postoperative visual acuity was improved in 17 cases (36.1%) with 2 lines or more and in 26 cases (55.3% ), Decreased 4 cases (8.6%); 3 postoperative IOP was significantly lower than before treatment (P <0.01); 4 functional filtration bleb were in early postoperative, after 6 months there were 41 cases (87.23%). The neovascularization subsided in the early postoperative period, and 4 cases (8.51%) appeared after 3 months. The incidence of intraoperative and early postoperative anterior chamber hemorrhage were 8 (17.02%) and 5 10.64%), no other serious complications occurred. Conclusion Argon laser combined with trabeculectomy can be used as an effective treatment for neovascular glaucoma.