摘要目的:探讨前部视网膜冷凝联合玻璃体切除术治疗中早期新生血管青光眼(neovascular glaucoma,NVG)的临床效果。方法:采用前部视网膜冷凝联合玻璃体切除术治疗中早期新生血管青光眼31例31眼,术中全视网膜光凝。结果:患者31眼,术前眼压41.1±6.2mmHg,术后观察3~25(平均9.8)mo,眼压22.6±6.9mmHg,术前术后眼压差别具有统计学意义(P=0.002);25例眼压控制正常,眼压19.8±2.4mmHg,6例眼压34±8.2mmHg,其中3例局部药物治疗眼压控制正常,2例行二次手术,玻璃体腔青光眼阀植入术后,眼压控制满意,1例无效,患眼无光感,疼痛,行眼内容摘除术。20眼视力有不同程度的提高,5例视力不变,5例视力下降,1例无光感。30例虹膜面新生血管绝大部分或完全消退,角膜透明,前房无积血,所有病例眼部疼痛消失或明显缓解。结论:前部视网膜冷凝联合玻璃体切除术可消退虹膜面的新生血管,有利于术后眼压的控制,恢复部分视力,为中早期新生血管性青光眼提供了一个行之有效的治疗方案。

AIM:To evaluate the effect of the treatment of neovascular glaucoma(NVG)by anterior retina condensation in combination with pars plana vitrectomy.METHODS:Tirty-one cases 31 eyes with diagnosed NVG were treated by anterior retina condensation in combination with pars plana vitrectomy,and whole-retina photocoagulation was applied as well.RESULTS:Preoperative intraocular pressure(IOP)was 41.1±6.2mmHg,after 3-25 months’ follow-up(average 9.8 months),the average of IOP was 22.6±6.9mmHg.There was statistical difference between IOP before and after operation.25 eyes IOP was controlled to be normal(19.8±2.4mmHg);3 eyes needed topical anti-glaucoma drops,and 2 eyes were carried out glaucoma valve implantation.1 eye was applied evisceration because of no light perception and eye-pain after operation.20 cases got a better visual acuity,5 cases remained the same level,5 cases decreased,and 1 case became no light perception.Neovascular on the surface of iris almost or completely disappeared in 30 cases,maintaining corneal transparency and non hematocele anterior chamber.Most follow-up cases eye-pain disappeared or obviously reliever.CONCLUSION:Treatment of anterior retina condensation in combination with pars plana virrectomy is effective in neovascular glaucoma.It can lead to better visual acuity,disappearance of iris neovessels,and decrease of IOP.

R779.6

中国云南省科技厅昆明医学院联合专项基金资助项目（No.2009C135）