【摘要】 目的　比较不同手术方法治疗新生血管性青光眼 (neovascular glaucoma,NVG)的疗效。方法　对 30例 (30只眼 ) NVG的不同手术方式进行回顾性分析 ,其中行单纯睫状体冷凝术 5例 ,单纯小梁切除术 9例 ,睫状体冷凝联合小梁切除术 9例 ,睫状体冷凝、睫状前动脉结扎联合小梁切除术 7例。比较患者手术前后主观眼痛症状、眼压 (intraocular pressure,IOP)及视力变化情况。随访 10～ 2 8个月。结果　单纯睫状体冷凝术 ,术后眼压仍高。单纯小梁切除术 ,术中玻璃体脱出及暴发性脉络膜上腔出血各 1例 ,术后 6例眼压高 ,经结膜下注射 5 - Fu后 ,出院时仍有 2例眼压稍高 ,随访后有 3例眼压高。睫状体冷凝联合小梁切除术与睫状体冷凝、睫状前动脉结扎联合小梁切除术两者术后眼压均降至正常 ,无明显差异 ,经随访后前者有 1例眼压高 ,后者有 4例发生眼球萎缩。以上各种手术术后眼痛症状明显缓解 ,视力无明显提高。结论　睫状体冷凝加睫状前动脉结扎联合小梁切除术 ,因术后低眼压发病率较高 ,远期可致眼球萎缩 ,故不主张联合行睫状前动脉结扎术。单纯睫状体冷凝术术后降眼压效果差。单纯小梁切除术术中并发症多 ,术后降眼压效果不理想。如将两者联合 ,术后降眼压效果显著 ,既可减少术中并发症的发生 ,又可避免术后因局部应更多还原

【Abstract】 Objective From comparing the clinical effects of different surgical management for neovascular glaucoma.Methods 30 eyes of NVG were retrospective analysis,including 5 eyes with cyclocryotherapy,9 eyes with an rontine filter surgery,9 eyes with cyclocryotherapy combining with filter surgery,7 eyes with cyclocryotherapy combining with filter surgery and ligation of anterior ciliary artery.The ophthalmalgia,intraocular pressures (IOPs) and visuity acuity were comparatively observed.The follow-up was 10～28 months.Results IOP was still high in those who underwent cyclocryotherapy.In the filter group,prolapse of vitreous and fulminant choroidal epistege hemorrhage occurred in two eyes respectively in the operation.Ocular hypertension occurred in 6 eyes after operation and there are 2 eyes still slightly high in IOP after subconjunctival injection with 5-Fu in discharge.In the followed-up,there are 3 eyes high in IOP.The cases of the cyclocyotherapy combining with filter surgery group and the cyclocryotherapy combining with filter surgery and ligation of anterior ciliary artery group got and idea IOP.In the followed-up,there were one eye of occurred hypertension in the former and four eyes of atrophy of eyeball in the latter.Ophthalmalgia in all cases is not remission obviously and visual acuity is not increased.Conclusions Although cyclocryotherapy combining with filter surgery and ligation of anterior ciliary artery was effective in reducing IOP.The complications of ocular hypertension was apparent and atrophy of eyeball can occur in the long-term followed-up.Now combining with ligation of anterior ciliary artery was not advocated.Merely cyclocyotherapy and filter surgery was difference in reducing IOP and the complications were apparent.If combining with them,it was effective in reducing IOP and complication and was advocated.更多还原