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目的探讨玻璃体切割加视网膜光凝联合Ahmed青光眼阀植入与小梁切除加睫状体及全周视网膜冷凝术治疗新生血管性青光眼(NVG)的疗效。方法选择我院2006年至2009年28例(28眼)新生血管青光眼患者。其中,对15例(15眼)新生血管性青光眼患者实行玻璃体切割加视网膜光凝联合Ahmed青光眼阀植入,13例(13眼)NVG患者行小梁切除加睫状体及全周视网膜冷凝术。结果术后1周和2个月冷冻组炎症明显重于青光眼阀组,术后虹膜新生血管均有不同程度回退,两组比较差异无统计学意义。所有病例术后随访6~24个月,两组眼压>21mm Hg的患者分别为青光眼阀组28%,冷冻组27.8%,两组比较差异无统计学意义。术后24个月两组视力变化比较,青光眼阀组明显优于冷冻组(P<0.01)。结论玻璃体切割加视网膜光凝联合Ahmed青光眼阀植入治疗NVG即能及时降低眼压,又能提高视力是治疗NVG的一种安全有效的方法,而小梁切除+睫状体及全周视网膜冷凝术是治疗NVG的一种简单经济有效的方法。
Objective To evaluate the efficacy of vitrectomy and retinal photocoagulation combined with Ahmed glaucoma valve implantation and trabeculectomy combined with ciliary body and peri-retinal condensation in the treatment of neovascular glaucoma (NVG). Methods 28 patients (28 eyes) with neovascular glaucoma from 2006 to 2009 in our hospital were selected. Among them, 15 patients (15 eyes) with neovascular glaucoma were treated with vitrectomy and retinal photocoagulation combined with Ahmed glaucoma valve implantation. Thirteen (13 eyes) patients with NVG underwent trabeculectomy combined with ciliary body transection . Results The inflammation in the frozen group at 1 week and 2 months postoperatively was significantly higher than that in the glaucoma valve group, and the iris neovascularization was regressed to varying degrees after operation. There was no significant difference between the two groups. All patients were followed up for 6 to 24 months. Two patients with IOP> 21mmHg were 28% in glaucoma valve group and 27.8% in frozen group, respectively. There was no significant difference between the two groups. Visual acuity changes of the two groups at 24 months after operation were significantly better than those in the frozen group (P <0.01). Conclusions Vitrectomy combined with retinal photocoagulation combined with Ahmed glaucoma valve implantation in treatment of NVG can reduce intraocular pressure in time and improve visual acuity. It is a safe and effective method to treat NVG. Trabeculectomy + ciliary body and peri-retinal condensation Surgery is a simple, cost-effective method of treating NVG.