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目的 :评价接触性二极管激光睫状体光凝 (TSCPC)对角膜移植术后难治性青光眼的治疗作用。方法 :对 2 5例 2 6眼角膜移植术后难治性青光眼进行接触性二极管激光经巩膜睫状体光凝。每个点的治疗功率从 1.6 W到 2 .8W,持续时间 2秒。初次治疗平均点数 2 7.3± 7.2 (范围 2 0～ 35 )。观察术后抗青光眼药物、IOP、视力、角膜移植片的变化和并发症的发生。平均随访时间 13.5± 6 .7月 (范围 :3～ 2 7月 )。结果 :9眼 (34.6 % )进行两次以上 TSCPC治疗。治疗前后平均应用抗青光眼药物的种类数分别是2 .7和 1.9种 ,治疗后明显降低用药的种类数 (P=0 .0 0 0 )。治疗前后平均 IOP分别是 33.6± 11.6 mm Hg (范围 :19～ 5 1mm Hg)和 17.2± 6 .3mm Hg(范围 :5～ 36 mm Hg)。IOP平均降低 16 mm Hg,治疗后明显降低 IOP(p<0 .0 0 1)。随访期内有 2 1眼 (81% )IOP在 6～ 2 2 mm Hg之间。治疗前 2 3眼透明的植片 ,治疗后 7眼 (30 .5 % )出现植片混浊。治疗前后视力变化无统计学上差异(p=0 .931)。无眼球萎缩 ,低眼压 1眼 (3.8% )。其它常见的并发症有眼部不适和前房闪辉 ,多在 1周内消失。结论 :二极管激光接触性 TSCPC是一种新的睫状体破坏性手术。它具有简单、有效、安全和重复性好的特性 ,对角膜移植术后难治性青光?
Objective: To evaluate the therapeutic effect of contact diode laser ciliary body photocoagulation (TSCPC) on refractory glaucoma after corneal transplantation. Methods: Twenty-five patients with refractory glaucoma after 26 corneal grafts underwent contact diode laser transscleral ciliary body photocoagulation. The healing power per spot ranged from 1.6 W to 2.8 W for 2 seconds. The average number of initial treatment was 2 7.3 ± 7.2 (range 20 ~ 35). To observe the postoperative anti-glaucoma drugs, IOP, visual acuity, corneal graft changes and complications. The average follow-up time was 13.5 ± 6.7 months (range: 3 to 27 months). Results: Nine eyes (34.6%) received more than two TSCPC treatments. The mean number of anti-glaucoma medications before and after treatment was 2.7 and 1.9, respectively. The number of medications was significantly decreased after treatment (P = 0.000). The mean IOP before and after treatment were 33.6 ± 11.6 mm Hg (range: 19 to 51 mm Hg) and 17.2 ± 6.3 mm Hg (range: 5 to 36 mm Hg), respectively. IOP decreased by an average of 16 mm Hg, and IOP was significantly reduced after treatment (p <0.0001). During follow-up, 21 eyes (81%) had IOP between 6 and 22 mm Hg. Transparent implants were obtained from 23 eyes before treatment, and opacification occurred in 7 eyes (30.5%) after treatment. There was no significant difference in visual acuity before and after treatment (p = 0.931). No eyeball atrophy, low intraocular pressure in 1 eye (3.8%). Other common complications are eye discomfort and anterior chamber glint, more than 1 week disappear. Conclusion: Diode laser contact TSCPC is a novel ciliary body destructive surgery. It has a simple, effective, safe and repeatable features, refractory glaucoma after corneal transplantation?