Kraus Courtney L, Tychsen Lawrence, Lueder Gregg T, Culican Susan M
J Pediatr Ophthalmol Strabismus. 2014 Mar-Apr;51(2):120-7. doi: 10.3928/01913913-20140211-01. Epub 2014 Feb 18.
Among the options for surgical management of pediatric glaucoma, destruction of the ciliary body reduces aqueous production and, consequently, intraocular pressure (IOP). Compared to more invasive filtering and shunt procedures, cyclodestruction is an attractive option for control of IOP in pediatric glaucomas.
The relative reduction in IOP, duration of effect, and comparable safety and efficacy of transscleral cyclophotocoagulation (TSCP) and endoscopic cyclophotocoagulation (ECP) in pediatric patients with glaucoma was studied in this retrospective chart review.
A reduction in IOP of 28.6% and 33.2% with TSCP and ECP, respectively, was found. Eyes treated with ECP underwent an average of 3.24 cyclodestructive procedures; eyes treated with TSCP underwent an average of 2.29 cyclodestructive treatments. These differences were not statistically significant. A final success rate of 67.6% after TSCP and 62% after ECP failed to significantly differ between the two groups. Consequently, two-thirds of the patients were able to avoid penetrating surgery and the associated risks after one or more cyclodestructive procedures.
TSCP and ECP are safe, effective, and comparable treatments for pediatric glaucomas. The results suggest that TSCP and ECP may be considered first-line therapy to achieve control of IOP in all forms of pediatric glaucoma. [J Pediatr Ophthalmol Strabismus 2014;51(2):120-127.].
在小儿青光眼的手术治疗方案中，睫状体破坏可减少房水生成，从而降低眼压（IOP）。与更具侵入性的滤过和分流手术相比，睫状体破坏术是控制小儿青光眼眼压的一种有吸引力的选择。
通过这项回顾性图表审查，研究了经巩膜睫状体光凝术（TSCP）和内镜睫状体光凝术（ECP）在小儿青光眼患者中眼压的相对降低、效果持续时间以及相当的安全性和有效性。
分别发现TSCP和ECP使眼压降低了28.6%和33.2%。接受ECP治疗的眼睛平均进行了3.24次睫状体破坏手术；接受TSCP治疗的眼睛平均进行了2.29次睫状体破坏治疗。这些差异无统计学意义。TSCP术后最终成功率为67.6%，ECP术后为62%，两组之间无显著差异。因此，三分之二 的患者在进行一次或多次睫状体破坏手术后能够避免穿透性手术及相关风险。
TSCP和ECP是治疗小儿青光眼安全、有效且效果相当的方法。结果表明TSCP和ECP可被视为控制各种形式小儿青光眼眼压的一线治疗方法。[《小儿眼科与斜视杂志》2014年；51(2):120 - 127。]
