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目的评价睫状体冷冻联合小梁切除术治疗新生血管性青光眼的临床效果。方法采用睫状体冷冻联合小梁切除术治疗新生血管性青光眼27例(27眼),观察术后眼压、视力及并发症等。结果术后眼压:术后随访6个月以上,手术成功23眼(85.19%)。23眼眼压从术前平均58.8 mm Hg降至22.16 mm Hg。术后视力:9眼(33.33%)无变化,光感10眼(37.04%),数指3眼(11.11%),0.01~0.05者3眼(11.11%),0.1~0.2者2眼(7.41%)。8眼(29.63%)视力有所提高。并发症:27例术后均有不同程度的疼痛症状加重,因睫状部反射性疼痛所致,经止痛镇静3 d后缓解。16眼有前房积血,因眼压降低所致,口服云南白药、皮质类固醇3~5 d后,积血吸收。结论采用睫状体冷冻联合小梁切除术治疗NVG,既降低眼压缓解症状,又改善了视网膜缺血、缺氧状态,对保护患者残存视力,维持眼压稳定有明确效果,不失为治疗新生血管性青光眼的有效方法之一。
Objective To evaluate the clinical effect of ciliary body cryosurgery combined with trabeculectomy in the treatment of neovascular glaucoma. Methods 27 cases (27 eyes) of neovascular glaucoma were treated with ciliary body cryosurgery and trabeculectomy. Intraocular pressure, visual acuity and complications were observed. Results Intraocular pressure (IOP) was followed up for more than 6 months after operation, and the operation was successful in 23 eyes (85.19%). The intraocular pressure decreased from 58.8 mm Hg to 22.16 mm Hg. Postoperative visual acuity showed no change in 9 eyes (33.33%), light perception in 10 eyes (37.04%), number in 3 eyes (11.11%), 0.01-0.05 in 3 eyes (11.11%), 0.1-0.2 eyes %). Eight eyes (29.63%) had better eyesight. Complications: 27 cases of postoperative pain were worsened in varying degrees, due to reflex ciliary pain caused by analgesic sedation 3 days after remission. 16 eyes have anterior chamber hemorrhage, due to decreased intraocular pressure, oral Yunnanbaiyao, corticosteroids 3 ~ 5 d, the hemorrhage absorption. Conclusions The treatment of NVG with ciliary body cryosurgery combined with trabeculectomy not only relieves the symptoms of intraocular pressure but also improves the status of retinal ischemia and hypoxia. It has a definite effect on protecting residual visual acuity and maintaining intraocular pressure stability in patients with neovascular One of the effective ways to treat glaucoma.