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@#AIM: To compare the therapeutic effects of high-intensity focused ultrasound cycloplasty(UCP)and cyclocryotherapy on refractory glaucoma.<p>METHODS:This retrospective study included 45 patients(81 eyes)with refractory glaucoma admitted to the hospital between January 2017 and December 2020. According to the treatment method, patients enrolled were divided into cyclocryotherapy group(22 patients, 40 eyes)and high-intensity UCP group(23 patients, 41 eyes). Changes in intraocular pressure at 1d, 1wk, 1 and 3mo after operation were compared between the two groups. The Numerical Rating Scale(NRS)was used to evaluate eyeball pain. Surgical results and complications in the two groups were compared. <p>RESULTS:The total effective rate of operation in the high-intensity UCP group was significantly higher than that in the control group(<i>P</i><0.05). Generalized estimation equation analysis showed that there were statistically significant differences in intraocular pressure and eyeball pain between the two groups before and after operation(all <i>P</i><0.05). There were statistically significant differences in intraocular pressure and eyeball pain between the two groups at different time points after operation(all <i>P</i><0.05). The incidence rates of complications such as conjunctival hyperemia, corneal edema, anterior chamber inflammatory exudation, reactive intraocular hypertension and hyphema in the high-intensity UCP group were significantly lower than those in the cyclocryotherapy group(<i>P</i><0.05).<p>CONCLUSION: High-intensity UCP is effective in the treatment of refractory glaucoma, with obvious advantages in reducing intraocular pressure, eyeball pain and complications as compared with cyclocryotherapy.
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@#AIM: To compare the effectiveness of diode transscleral cyclophotocoagulation(CPC)and transscleral cyclocryotherapy(CCT)for the intraocular pressure(IOP)control and postoperative complications of absolute glaucoma. <p>METHODS: This was a prospective case observation study. Totally 85 cases with absolute glaucoma which were admitted by Tianjin Eye Hospital were randomly assigned in 2 groups to receive either CPC or CCT. IOP, the numbers of anti-glaucoma medication, inflammatory reaction of anterior segment and postoperative ocular pain which was evaluated by Visual Analogue Scale(VAS)in two groups were recorded at eight points in time: the day before surgery and 1d, 3d, 1wk, 2wk, 1mo, 3mo and 6mo after surgery. The generalized estimated equation was used to compare all the indexes before and after operation and the difference of success rate between the two surgical methods. <p>RESULTS: Compared with CPC group, IOP of CCT group decreased less than that before surgery at 1, 3d, 1, 2wk, 1mo after surgery, VAS score decreased less than that before surgery at 3d, 1, 2wk, 1mo after surgery, and the number of anti-glaucoma drugs decreased less than that before surgery at 1, 3d, 1, 2wk after surgery(<i>P</i><0.05). Compared with CPC group, the complete success rate of CCT group was higher than that at 1d after surgery at 3d, 1, 2wk, 1, 3, 6mo after operation, but only the difference of 3, 6mo after surgery was statistically significant(<i>P</i><0.05). Compared with CPC group, anterior chamber flash grade of CCT group increased more than that before surgery at 3d, 1, 2wk, 1mo after surgery, conjunctival congestion grade increased more than that before surgery at 1, 3d, 1, 2wk after surgery, corneal edema grade increased more than that before surgery at 3d, 1, 2wk, 1mo after surgery(<i>P</i><0.05).<p>CONCLUSION: Compared with CPC, the rate of IOP reduction after CCT was slower, the inflammatory reaction of anterior segment and discomfort of eyeball were more severe and lasted longer. Therefore, the duration of anti-inflammatory drugs and anti-glaucoma medications should be extended after the surgery.
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@#AIM: To observe the clinical efficacy and safety in the treatment for refractory glaucoma by two kinds of cyclodestructive procedures.<p>METHODS: A retrospective study of 50 patients(50 eyes)with refractory glaucoma diagnosed in our hospital between January 2018 and October 2018. Ultrasound cyclo plasty(UCP)were performed on 30 eyes and cyclocryotherapy were performed on 20 eyes, introcular pressure(IOP), pain grade scores and complications after operation were followed up.<p>RESULTS: The average IOP of the UCP group on 1d, 1wk, 1mo and 3mo were 29.27±10.40, 23.87±8.61, 25.27±9.95, 23.70±10.06mmHg compared with 43.97±10.39mmHg before operation. The average IOP of the cyclocryotherapy group on 1d, 1wk, 1mo and 3mo were 22.15±7.78, 20.80±8.44, 22.50±7.12, 24.20±8.43mmHg compared with 47.30±8.53mmHg before operation. The IOP in both group was significantly reduced(<i>P<</i>0.01). The pain grade scores of patients in the UCP group at 1d, 1wk, 1mo and 3mo after surgery were significantly lower than those before operation(<i>P</i><0.05), but there was no significant difference in the cyclocryotherapy group at 1d after surgery(<i>P></i>0.05). There were no serious complications in the UCP group, four eyes appeared conjunctival hyperemia and one eye appeared superficial punctuate keratitis; but there were 16 eyes(80.00%)in the cyclocryotherapy group: ten eyes appeared conjunctival hyperemia and six eyes appeared anterior chamber hemorrhage. <p>CONCLUSION: UCP is safe and convenient surgery for refractory glaucoma, and has significant effect on reducing intraocular pressure, alleviating ocular pain and decreasing complications.
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To investigate the clinical efficacy of cyclocryotherapy combined trabeculectomy and single cyclocryotherapy for neovascular glaucoma (NVG). ●METHODS:Totally 82 patients with NVG from February 2012 to June 2013 in our hospital were selected and randomly divided into observation group and control group, each 41 cases. Patients in control group were given single cyclocrytherapy, and patients in observation group were given cyclocryotherapy combined trabeculectomy. The visual acuity, intraocular pressure and postoperative complications of two groups were observed. ●RESULTS: After postoperative six months, the improvement rate of visual acuity in observation group was 61. 0%, which was significantly higher than that of control group ( 41. 5%), the difference was statistically significant (χ2 = 3. 843, P = 0. 018). lntraocular pressure of observation group was significantly lower than that of control group, the difference was statistically significant (P0. 05). ●CONCLUSlON: Compared with single cyclocryotherapy, cyclocryotherapy combined trabeculectomy has advantages of low intraocular pressure, less postoperative complications, and high success rate, so it is worthy of promotion.
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PURPOSE: To report a case of chronic hypotony maculopathy caused by traumatic cyclodialysis cleft and treated with 20% sulfur hexafluoride (SF6) gas tamponade with cyclocryotherapy. CASE SUMMARY: A 39-year-old woman with a history of blunt trauma developed a unilateral chronic ocular hypotony in her left eye. She was treated with topical atropine sulphate 1% for 2 months. Three years later, she was referred to our clinic for evaluation and treatment of persistent hypotony. The intraocular pressure (IOP) was 4 mm Hg and the best corrected visual acuity was 0.4. B-scan echography revealed a choroidal effusion and fundus examination showed choroidal detachment and macular folds. Gonioscopy examination revealed cyclodialysis cleft from the direction of 7 o'clock to 11 o'clock. A single bubble of SF6 20% (0.4 cc) was injected into the vitreous cavity and transconjunctival cyclocryotherapy was performed under retrobulbar anesthesia. Six months later, the IOP was 12 mm Hg and the best corrected visual acuity was 1.0. B-scan echograpy and fundus examination showed the disappearance of the choroidal effusion. CONCLUSIONS: Gas tamponade with cyclocryotherapy may be useful in cases of cyclodialysis cleft that failed to respond to medical therapy.
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Adult , Female , Humans , Anesthesia , Atropine , Choroid , Eye , Gonioscopy , Intraocular Pressure , Ocular Hypotension , Sulfur Hexafluoride , Visual AcuityABSTRACT
Objective To compare the clinical effects of different surgical management for obsolute glaucoma.Methods 31 eyes of absolute glaucoma were retrospectively analyzed,including 23 case 23 eyes(A group) with cyclocryotherapy,8 case 8 eyes(B group)with cyclocryotherapy combining with paracentesis of anterior chamber,the pain and duration were comparatively observed.Results In the cyclocryotherapy,the pain occurred in 23 eyes,the duration time was 3 to 10 days,the average time was 6.8 days.While 4 eyes occurred pain in the cyclocryotherapy combining with paracentesis of anterior chamber,the duration time was 1 to 3 days,the average time was 2.3 days.There was significant difference(P