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高剂量超声睫状体成形术治疗难治性青光眼的疗效与安全性

Efficacy and safety of high-dose ultrasound cyclo-plasty procedure in refractory glaucoma.

作者信息

Liu He-Ting, Zhang Qing, Jiang Zheng-Xuan, Xu Yu-Xin, Wan Qian-Qian, Tao Li-Ming

机构信息

Department of Ophthalmology, the Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China.

出版信息

Int J Ophthalmol. 2020 Sep 18;13(9):1391-1396. doi: 10.18240/ijo.2020.09.09. eCollection 2020.

Abstract

AIM

To evaluate the efficacy and safety of high-dose ultrasound cyclo-plasty (UCP) for the treatment of refractory glaucoma in Chinese patients.

METHODS

In this 6-month retrospective study, 37 eyes of 37 patients suffering from severe glaucoma with uncontrolled intraocular pressure (IOP) of ≥21 mm Hg underwent 8-s ultrasonic cyclocoagulation with ten active piezoelectric elements. A complete ophthalmic examination was performed before and at 1d, 1, 3, 6mo after UCP. Therapeutic success was defined as IOP reduction from baseline ≥20% and IOP ≥5 mm Hg without adding new glaucoma medication compare to baseline at the 6-month follow-up visit. In addition to mean IOP at each follow-up visit, medications used and complications were also detected and compared to baseline.

RESULTS

After UCP procedure, the mean IOP was significantly reduced (<0.01) from the preoperative 44.1±11.9 mm Hg to postoperative 26.7±11.8 mm Hg at 3mo, and 30.4±14.5 mm Hg at 6mo. The overall mean IOP reductions achieved at 3 and 6mo were 39% and 31% compared to baseline IOP. Sixty-one percent of patients responded well to UCP treatment with a mean IOP reduction of 48% at 3mo and 42% at 6mo. Ocular pain in most of patients were alleviated. No serious intraoperative or postoperative complications occurred.

CONCLUSION

High-dose UCP treatment is an effective and safe procedure to reduce IOP in Chinese patients with severe glaucoma.

摘要

目的

评估大剂量超声睫状体成形术(UCP)治疗中国患者难治性青光眼的疗效和安全性。

方法

在这项为期6个月的回顾性研究中,37例严重青光眼患者的37只眼,眼压(IOP)≥21 mmHg且控制不佳,接受了使用10个有源压电元件的8秒超声睫状体凝固术。在UCP术前以及术后1天、1个月、3个月、6个月进行了全面的眼科检查。治疗成功的定义为:在6个月随访时,与基线相比眼压降低≥20%且眼压≥5 mmHg,且未添加新的青光眼药物。除了每次随访时的平均眼压外,还检测了所用药物和并发症,并与基线进行比较。

结果

UCP术后,平均眼压从术前的44.1±11.9 mmHg显著降低(<0.01),3个月时降至术后的26.7±11.8 mmHg,6个月时降至30.4±14.5 mmHg。与基线眼压相比,3个月和6个月时总体平均眼压降低分别为39%和31%。61%的患者对UCP治疗反应良好,3个月时平均眼压降低48%,6个月时降低42%。大多数患者的眼痛得到缓解。未发生严重的术中或术后并发症。

结论

大剂量UCP治疗是降低中国严重青光眼患者眼压的一种有效且安全的方法。

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