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目的探讨青光眼阀植入联合广泛视网膜光凝治疗新生血管性青光眼的疗效。方法回顾性分析了16例(16眼)新生血管性青光眼接受青光眼阀植入及广泛视网膜光凝治疗的效果,其中6眼同时行晶状体摘出,4眼同时行晶状体摘出、玻璃体切除。术后随访8~24个月,分析术前与术后的眼压、视力、虹膜表面新生血管及术后并发症。结果术前平均眼压:(45.90±7.84)mmHg(31~67 mmHg)。手术后平均眼压:1周为(14.15±3.35)mmHg,2周为(16.30±4.20)mm-Hg,4周为(17.85±3.15)mmHg,12周为(15.60±2.75)mmHg,末次复诊眼压(18.50±3.75)mmHg。术后末次复诊视力提高11眼,视力不变5眼,无视力下降或丧失者。术后并发症主要有:前房积血3眼,前房形成迟缓及低眼压6眼,引流管堵塞1眼,脉络膜部分脱离1眼。16眼虹膜新生血管全部或部分消退,临床症状缓解。结论青光眼阀植入联合广泛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 investigate the efficacy of glaucoma valve implantation combined with extensive retinal photocoagulation in the treatment of neovascular glaucoma. Methods The effect of glaucoma valve implantation and extensive retinal photocoagulation in 16 cases (16 eyes) of neovascular glaucoma was retrospectively analyzed. Among them, 6 eyes were simultaneously extirpated and 4 eyes underwent both vitrectomy and vitrectomy. The patients were followed up for 8-24 months. The preoperative and postoperative intraocular pressure, visual acuity, neovascularization and postoperative complications were analyzed. Results The average preoperative intraocular pressure: (45.90 ± 7.84) mmHg (31 ~ 67 mmHg). The mean intraocular pressure (IOP) after operation was (14.15 ± 3.35) mmHg for 1 week, (16.30 ± 4.20) mmHg for 2 weeks, (17.85 ± 3.15) mmHg for 4 weeks and (15.60 ± 2.75) mmHg for 12 weeks. Intraocular pressure (18.50 ± 3.75) mmHg. Postoperative follow-up vision improved 11 eyes, 5 eyes unchanged, no loss of vision loss or loss. Postoperative complications include: 3 cases of anterior chamber hemorrhage, anterior chamber hypoplasia and low intraocular pressure in 6 eyes, drainage tube obstruction in 1 eye, part of the choroidal detachment. 16 iris neovascularization subsided in all or part of the clinical symptoms. Conclusion Glaucoma valve implantation combined with extensive retinal photocoagulation for the treatment of neovascular glaucoma can both reduce intraocular pressure and save or improve eyesight. It is a safe and effective method for the treatment of neovascular glaucoma.