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硅油眼术后患者慢凝血经巩膜睫状体光凝术。

Slow Coagulation Transscleral Cyclophotocoagulation for Postvitrectomy Patients With Silicone Oil-induced Glaucoma.

机构信息

Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL.

Department of Ophthalmology, Research Institute of Ophthalmology, Giza, Egypt.

出版信息

J Glaucoma. 2021 Sep 1;30(9):789-794. doi: 10.1097/IJG.0000000000001893.

Abstract

PRECIS

Slow coagulation transscleral cyclophotocoagulation (TSCPC) is an effective and safe glaucoma surgery in patients with medically uncontrolled silicone oil (SO)-induced glaucoma.

PURPOSE

The purpose of this study was to report the outcomes of slow coagulation continuous wave TSCPC in patients with medically uncontrolled secondary glaucoma following pars plana vitrectomy (PPV) and intravitreal SO injection.

PATIENTS AND METHODS

This retrospective study enrolled patients with medically uncontrolled glaucoma secondary to PPV with SO injection who underwent TSCPC using slow coagulation TSCPC settings (power of 1250 mW and duration of 4 s). The primary outcome measure was surgical success at 12 months. Surgical success was defined as an intraocular pressure 6 to 21 mm Hg and reduced ≥20% from baseline, no reoperation for glaucoma, and no loss of light perception vision. Secondary outcome measures included number of glaucoma medications, visual acuity changes, and surgical complications.

RESULTS

A total of 18 eyes of 18 patients were included in the study. The mean age and follow-up of the patients were 51.94±14.5 years and 16.3±3.5 months, respectively. The mean intraocular pressure decreased from 29.7±9.6 mm Hg preoperatively to 14.6±6.5 mm Hg at 12 months postoperatively (P<0.001). Glaucoma medications were reduced from 4.2±0.9 at baseline to 1.9±1.3 at 12 months after TSCPC (P<0.001). A nonsignificant change of logarithm of the minimum angle of resolution visual acuity was observed at 12 months (P=0.722). The success rate at 12 months was 72.2%. No major complications were reported during the first year of follow-up.

CONCLUSION

Slow coagulation TSCPC had high efficacy and minimal complications when used as an initial glaucoma surgical procedure in patients with SO-induced glaucoma.

摘要

中文摘要

经巩膜睫状体光凝(TSCPC)是硅油(SO)诱导青光眼患者的一种有效且安全的治疗方法。目的:本研究旨在报告经巩膜睫状体光凝术(TSCPC)治疗玻璃体切除术后硅油眼内注气并发药物无法控制的继发性青光眼患者的结果。方法:本回顾性研究纳入了因玻璃体切除术后硅油眼内注气并发药物无法控制的青光眼患者,这些患者采用慢凝持续波 TSCPC 治疗,设置功率为 1250 mW,持续时间为 4 s。主要观察指标为 12 个月时的手术成功率。手术成功定义为眼压 6 至 21 mmHg,与基线相比降低≥20%,无需再次手术治疗青光眼,且无光感视力丧失。次要观察指标包括青光眼药物使用数量、视力变化和手术并发症。结果:共纳入 18 例 18 眼患者。患者的平均年龄和随访时间分别为 51.94±14.5 岁和 16.3±3.5 个月。患者术前平均眼压为 29.7±9.6mmHg,术后 12 个月时降至 14.6±6.5mmHg(P<0.001)。术前患者平均使用 4.2±0.9 种降眼压药物,术后 12 个月时降至 1.9±1.3 种(P<0.001)。术后 12 个月时最佳矫正视力的最小分辨角对数(logMAR)变化无显著差异(P=0.722)。12 个月时的手术成功率为 72.2%。在随访的第一年,未发生重大并发症。结论:在硅油眼继发青光眼患者中,慢凝 TSCPC 作为初始青光眼手术治疗方法具有较高的疗效和最小的并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/198d/8404953/60b567b6f546/ijg-30-789-g001.jpg

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