微脉冲经巩膜激光治疗在睫状体转移继发的难治性青光眼中的有效性。
Effectiveness of micropulse transscleral laser therapy in uncontrolled glaucoma secondary to ciliary body metastasis.
作者信息
Suvannachart Pukkapol, Jaru-Ampornpan Patcharaporn, Chansangpetch Sunee, Manassakorn Anita, Tantisevi Visanee, Ratanawongphaibul Kitiya
机构信息
Glaucoma Research Unit, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama IV Road, Pathumwan, Bangkok, Thailand.
Department of Ophthalmology, Suddhavej Hospital, Mahasarakham University, 269 Nakornsawan Road, Muang, Mahasarakham, Thailand.
出版信息
Am J Ophthalmol Case Rep. 2021 Aug 8;23:101190. doi: 10.1016/j.ajoc.2021.101190. eCollection 2021 Sep.
PURPOSE
To report a case of ciliary body metastasis with uncontrolled glaucoma that was successfully treated with micropulse transscleral laser therapy (MPTLT).
OBSERVATIONS
A case of a 44-year-old female with uncontrolled glaucoma secondary to ciliary body metastasis from pulmonary adenocarcinoma. Antiglaucoma medications, intravitreal ranibizumab injection and local radiotherapy were ineffective in reducing her intraocular pressure (IOP) and ocular pain. MPTLT using a power setting of 2,000 mW, 31.3% duty cycle, and 140 seconds over 180 degrees demonstrated favorable IOP reduction (from 31 to 8 mmHg) on the first postoperative day without either ocular pain or postoperative complications. IOP remained controlled until she died from hemoperitoneum 18 days after hospital discharge.
CONCLUSIONS AND IMPORTANCE
MPTLT can be a safe and effective procedure for IOP control in intraocular metastasis patients with uncontrolled glaucoma.
目的
报告一例睫状体转移瘤伴难治性青光眼患者，经微脉冲经巩膜激光治疗（MPTLT）成功治愈。
观察结果
一名44岁女性患者，因肺腺癌睫状体转移继发难治性青光眼。抗青光眼药物、玻璃体内注射雷珠单抗及局部放疗均无法有效降低其眼压（IOP）及眼痛。采用2000 mW功率设置、31.3%占空比、180度范围照射140秒的MPTLT治疗，术后第一天眼压显著降低（从31 mmHg降至8 mmHg），且无眼痛或术后并发症。出院18天后患者因腹腔积血死亡，在此期间眼压一直得到控制。
结论与意义
对于伴有难治性青光眼的眼内转移瘤患者，MPTLT是一种安全有效的眼压控制方法。
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