结论:经巩膜二极管激光睫状体光凝术在大量人群和不同类型的青光眼中是有效和安全的,但在NVG组中效果最差。
目的:我们旨在研究经巩膜二极管激光睫状体光凝(TDLC)在不同类型难治性青光眼患者中的临床疗效。
方法:使用患者图表,我们回顾性分析了TDLC的成功和并发症,分为6组:原发性青光眼(116只眼),外伤(41眼),新生血管性青光眼(NVG,84只眼睛),玻璃体视网膜手术后(VRS后,79只眼睛),穿透性角膜移植术(PK,47只眼睛),和杂项(40眼)。失败定义为眼内压(IOP)>22mmHg或<5mmHg,需要进一步的青光眼手术,以及随访期间光感知的丧失。
结果:总体而言,平均随访时间为33.4±17.4个月,平均总能量为109.2±56.5J,平均眼压下降率为41.8%。两组总能量递送率和眼压降低率相似(均P>0.05)。36个月成功的概率为71.5%,70.7%,55.9%,77.2%,72.3%,原发性青光眼占72.5%,创伤,NVG,VRS后,PK,和杂组,分别。NVG组的成功率明显低于其他组(P=0.009)。严重的并发症包括NVG组的1只眼(0.2%)和NVG(3只眼)的7只眼(1.7%)的慢性低眼压,外伤(2眼),VRS后(1眼),和原发性青光眼(1眼)组。
结论:尽管发现TDLC是安全的,从长远来看,有效的方法,在NVG的眼睛中效果最差。
CONCLUSIONS: Transscleral diode laser cyclophotocoagulation (TDLC) is effective and safe in a large population and different types of glaucoma but is least effective in the neovascular glaucoma (NVG) group.
OBJECTIVE: We aimed to investigate the clinical outcomes of TDLC in a large cohort of patients with different types of refractory glaucoma.
METHODS: Using patient charts, we retrospectively analyzed the success and complications of TDLC performed on eyes categorized into 6 groups: primary glaucoma (116 eyes), trauma (41 eyes), NVG (84 eyes), post-vitreoretinal surgery (post-VRS, 79 eyes), penetrating keratoplasty (47 eyes), and miscellaneous (40 eyes). Failure was defined as intraocular pressure (IOP) >22 mm Hg or <5 mm Hg, the need for further glaucoma surgery, and the loss of light perception during follow-up.
RESULTS: Overall, the mean follow-up time was 33.4 ± 17.4 months, the mean total energy delivered was 109.2 ± 56.5 J, and the mean IOP reduction rate was 41.8%. Total energy delivered and IOP reduction rates were similar between the groups (all P > 0.05). The probability of success at 36 months was 71.5%, 70.7%, 55.9%, 77.2%, 72.3%, and 72.5% in primary glaucoma, trauma, NVG, post-VRS, penetrating keratoplasty, and miscellaneous groups, respectively. The NVG group showed a significantly lower success rate ( P = 0.009) than the other groups. Significant complications consisted of phthisis bulbi in 1 eye (0.2%) in the NVG group and chronic hypotony in 7 eyes (1.7%) in the NVG (3 eyes), trauma (2 eyes), post-VRS (1 eye), and primary glaucoma (1 eye) groups.
CONCLUSIONS: Although TDLC was found to be a safe, effective method in the long term, it was least effective in eyes with NVG.