Uram M
Manhattan Eye, Ear and Throat Hospital, New York.
Ophthalmology. 1992 Dec;99(12):1823-8. doi: 10.1016/s0161-6420(92)31718-x.
To evaluate the potential efficacy of ophthalmic laser microendoscope photocoagulation of the ciliary processes in the management of intractable neovascular glaucoma.
Ten patients with intractable neovascular glaucoma underwent ophthalmic laser microendoscope ciliary process ablation via a pars plana incision. The device and surgical technique are discussed.
Preoperative intraocular pressure (IOP) ranged from 36 mmHg to 62 mmHg (mean, 43.6 mmHg). Postoperative final IOP ranged from 3 mmHg to 27 mmHg (mean, 15.3 mmHg). This represents an absolute decrease of 28.3 mmHg (65%). Postoperatively, 9 eyes had an IOP of less than 21 mmHg, although 3 of these eyes required medication. One eye attained a final IOP of 27 mmHg. All eyes were treated once. Nine patients were treated with carbonic anhydrase inhibitors preoperatively, and six patients were able to discontinue this medication postoperatively. Phthisis was not observed, but hypotony evolved in two eyes with chronic retinal detachment. Follow-up ranged from 6 to 11 months (mean, 8.8 months).
This new therapeutic modality, which combines endoscopic visualization of the ciliary processes with diode laser photocoagulation, can be effective in the management of intractable neovascular glaucoma.
评估眼科激光微内镜光凝睫状体在治疗难治性新生血管性青光眼中的潜在疗效。
10例难治性新生血管性青光眼患者经睫状体扁平部切口行眼科激光微内镜睫状体消融术。对该设备及手术技术进行了讨论。
术前眼压范围为36 mmHg至62 mmHg（平均43.6 mmHg）。术后最终眼压范围为3 mmHg至27 mmHg（平均15.3 mmHg）。这意味着绝对降低了28.3 mmHg（65%）。术后，9只眼眼压低于21 mmHg，尽管其中3只眼需要药物治疗。1只眼最终眼压为27 mmHg。所有眼睛均接受一次治疗。9例患者术前使用碳酸酐酶抑制剂，6例患者术后能够停用该药物。未观察到眼球痨，但2只患有慢性视网膜脱离的眼睛出现了低眼压。随访时间为6至11个月（平均8.8个月）。
这种将睫状体的内镜可视化与二极管激光光凝相结合的新治疗方式，在难治性新生血管性青光眼的治疗中可能有效。
