超声睫状体成形术治疗青光眼的临床应用研究进展OA
Research progress on clinical application of ultrasound cycloplasty in the treatment of glaucoma
青光眼是世界首位不可逆性致盲性眼病,降眼压是唯一被证实有效的干预措施.手术是降低眼压的主要途径,近年来创伤更小、术后炎症反应更轻、并发症更少的微创青光眼手术逐渐在临床得到应用.超声睫状体成形术(ultrasound cycloplasty,UCP)是一种新型微创青光眼治疗技术.本文综述了国内外现有研究,表明UCP在治疗各种类型青光眼中均表现出良好的降眼压效果,但不同类型青光眼疗效存在一定差异.UCP可减少术后局部抗青光眼药物的使用数量,同时显示出较少的并发症和较轻的术后反应.与其他睫状体分泌功能减弱性手术相比,该手术在缓解难治性青光眼患者因高眼压导致的局部疼痛方面尤为有效.青光眼类型、超声探头型号匹配及治疗扇区数量是影响疗效的主要因素,其适应证的准确把握及手术参数设计的优化将进一步提高其治疗效果.本文归纳了UCP治疗青光眼的作用原理、手术操作与术后用药、适应证与禁忌证、有效性、安全性及其疗效的影响因素,以期为其临床应用和研究提供参考依据.
Glaucoma is the leading cause of irreversible blindness worldwide.Lowering intraocular pressure(IOP)is the only proven intervention to effectively prevent visual field deterioration and slow the progression of glaucoma.Surgery plays a critical role in reducing IOP,with traditional glaucoma surgeries focusing primarily on classic filtration procedures.In recent years,minimally invasive glaucoma surgeries(MIGS),characterized by less trauma,milder postoperative inflammation,and fewer complications,have been increasingly applied and continuously refined in clinical practice.Ultrasound cycloplasty(UCP)is a novel,minimally invasive technique for glaucoma treatment.This article reviews existing research both domestically and internationally,showing that UCP demonstrates good IOP-lowering effects in various types of glaucoma,though its efficacy varies across different glaucoma types.UCP reduces the need for postoperative anti-glaucoma medications,while also exhibiting fewer complications and milder postoperative reactions.Compared with other ciliary body function-reducing surgeries,UCP is particularly effective in alleviating local pain caused by elevated IOP in patients with refractory glaucoma.The type of Glaucoma,matching of the ultrasound probe model,and the number of treatment sectors are key factors influencing UCP efficacy.Accurate selection of indications and optimization of surgical parameters will further enhance its therapeutic outcomes.This article summarizes the mechanisms,surgical procedures,postoperative medication,indications and contraindications,efficacy,safety,and factors influencing UCP outcomes in glaucoma treatment,aiming to provide a reference for its clinical application and research.
施欢洋;李妍霖;葛坚;左成果
中山大学中山眼科中心,眼病防治全国重点实验室,广东省眼科视觉科学重点实验室,广州 510060
临床医学
青光眼超声睫状体成形术高强度聚焦超声
glaucomaultrasound cycloplastyhigh-intensity focused ultrasound
《眼科学报》 2024 (008)
395-401 / 7
评论