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二极管激光经巩膜睫状体光凝术在复杂视网膜脱离玻璃体腔注射硅油后青光眼治疗中的作用

Effect of diode laser trans-scleral cyclophotocoagulation in the management of glaucoma after intravitreal silicone oil injection for complicated retinal detachments.

作者信息

Han S K, Park K H, Kim D M, Chang B L

机构信息

Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.

出版信息

Br J Ophthalmol. 1999 Jun;83(6):713-7. doi: 10.1136/bjo.83.6.713.

Abstract

AIMS

To evaluate the effect of trans scleral cyclophotocoagulation (TSCPC) on intraocular pressure (IOP) in the eyes retaining intravitreal silicone oil with medically uncontrolled secondary glaucoma following intravitreal silicone oil injection.

METHODS

Medical records of 11 eyes of 11 patients who underwent TSCPC for medically uncontrolled glaucoma without pupillary block following intravitreal silicone oil injection for complicated retinal detachment were reviewed retrospectively. In all cases, intravitreal silicone oil was not removed for fear of retinal redetachment. Diode laser contact TSCPC was performed at a power of 1.5-2.5 W, for a duration of 2 seconds, and with 20-27 applications. IOP, number of glaucoma medications, and success rate were evaluated.

RESULTS

After a mean follow up period of 52.5 (SD 8.2) (range 42-68) weeks, the mean pretreatment level of IOP, 43.0 (14.4) (26-67) mmHg, had fallen to 14.5 (4.3) (7-20) mm Hg (p=0.003). The number of glaucoma medications was reduced from 2.6 (0.8) to 0.6 (1.0) (p= 0.005). Qualified success was achieved in nine eyes (81.8%) and complete success in six (54.5%). After TSCPC, patients' retinal status had not changed.

CONCLUSION

Patients with medically uncontrolled glaucoma secondary to intravitreal silicone oil injection can be treated with TSCPC in spite of the retained intravitreal silicone oil.

摘要

目的

评估经巩膜睫状体光凝术(TSCPC)对玻璃体内注入硅油后药物治疗无法控制的继发性青光眼且保留玻璃体内硅油的患眼眼压(IOP)的影响。

方法

回顾性分析11例患者11只眼的病历,这些患者因复杂性视网膜脱离行玻璃体内硅油注射后,因药物治疗无法控制的无瞳孔阻滞性青光眼接受了TSCPC。所有病例中,因担心视网膜再次脱离未取出玻璃体内硅油。采用二极管激光接触式TSCPC,功率为1.5 - 2.5W,持续时间2秒,进行20 - 27次照射。评估眼压、青光眼药物使用数量及成功率。

结果

平均随访52.5(标准差8.2)(范围42 - 68)周后,术前平均眼压水平43.0(14.4)(26 - 67)mmHg降至14.5(4.3)(7 - 20)mmHg(p = 0.003)。青光眼药物使用数量从2.6(0.8)降至0.6(1.0)(p = 0.005)。9只眼(81.8%)取得合格成功,6只眼(54.5%)取得完全成功。TSCPC后,患者视网膜状况未改变。

结论

尽管玻璃体内保留硅油,但玻璃体内注入硅油继发药物治疗无法控制的青光眼患者可采用TSCPC治疗。

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