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目的观察引流阀植入联合视网膜光凝治疗新生血管性青光眼的临床效果。方法13例13眼新生血管性青光眼接受引流阀植入及视网膜光凝治疗,其中4眼同时行晶体摘除,3眼同时行晶体摘除、玻璃体切割。术后随访5～18个月,分析术前与术后的眼压、视力变化及术后并发症。结果术前视力:光感～0.2,术前平均眼压:43.6mmHg(29～61mmHg)。手术后平均眼压1周为15mmHg,2周为18.5mmHg,4周为19.2mmHg,12周为17.1mmHg,末次复诊眼压19.4mmHg。术后末次复诊视力提高9眼,视力不变4眼,无视力下降及丧失者。术后并发症主要有:前房出血2眼,前房形成迟缓及低眼压4眼,引流管堵塞1眼,脉络膜部分脱离1眼。13眼虹膜新生血管全部或部分消退,临床症状缓解。论结引流阀植入联合视网膜光凝术治疗新生血管性青光眼既能及时降低眼压,又能拯救或提高视力,是治疗新生血管性青光眼的一种安全而有效的方法。
Objective To observe the clinical effect of drainage valve implantation combined with retinal photocoagulation in the treatment of neovascular glaucoma. Methods Thirteen eyes with neovascular glaucoma underwent drainage valve implantation and retinal photocoagulation. Thirteen eyes underwent simultaneous lens ablation and three eyes underwent simultaneous lens ablation and vitrectomy. The patients were followed up for 5 to 18 months. The intraocular pressure, visual acuity and postoperative complications were analyzed before and after operation. Results preoperative visual acuity: light perception ~ 0.2, preoperative average intraocular pressure: 43.6mmHg (29 ~ 61mmHg). The mean IOP after surgery was 15 mmHg for 1 week, 18.5 mmHg for 2 weeks, 19.2 mmHg for 4 weeks, 17.1 mmHg for 12 weeks, and 19.4 mmHg for the last visit. Postoperative visual acuity increased 9 times the last visit, unchanged vision 4, no loss of vision and loss of those. Postoperative complications were: 2 cases of anterior chamber hemorrhage, anterior chamber hypothyroidism and low intraocular pressure in 4 eyes, drainage tube obstruction in 1 eye, part of the choroidal detachment. 13 iris neovascularization subsided in all or part of the clinical symptoms. Conclusion The treatment of neovascular glaucoma with the combination of drainage and valve implantation combined with retinal photocoagulation is a safe and effective method for the treatment of neovascular glaucoma, which can both reduce intraocular pressure and save or improve eyesight in time.