睫状体破坏手术是用来降低青光眼眼压的有效手段,超声睫状体成形术(UCP)是通过微型换能器产生高强度聚焦超声,诱导睫状体凝固的计算机辅助、自动化的手术。UCP主要通过破坏睫状突上皮细胞和增加葡萄膜巩膜通路引流2个机制降低眼压。UCP适应证广泛,主要应用于难治性青光眼,包括有和无抗青光眼手术史的患者,能够有效降低眼压,安全性高,可重复治疗,可以作为非侵入性青光眼手术的有效替代方案。闭角型青光眼、术前眼压高、使用第2代探头和治疗暴露时间长的患者采用UCP治疗效果更好。本文就UCP在青光眼中应用的适应证、手术方法、注意事项、作用机制、有效性、安全性、影响治疗效果的因素及目前关于UCP治疗青光眼研究的不足进行综述,以期为其临床治疗和研究提供参考。
Surgery to destroy the ciliary body is an effective means to reduce the intraocular pressure in glaucoma.Ultrasound cycloplasty (UCP) is a computer-aided automatic operation that produces high-intensity focused ultrasound to induce ciliary body coagulation through miniaturized transducers.UCP reduces intraocular pressure mainly by destroying ciliary process epithelial cells and increasing uveoscleral outflow.With a wide range of indications, UCP is mainly used for refractory glaucoma, including patients with or without history of anti-glaucoma surgery.It can reduce intraocular pressure safely and efficiently with good outcome, and can be used as a reproducible effective alternative to non-invasive glaucoma surgery.The effect of UCP is better in patients with angle-closure glaucoma, high intraocular pressure before operation, application of second-generation probe and long exposure time.In order to provide reference for clinical treatment and research, the indications, surgical procedures, precautions, mechanism of action, effectiveness, safety, factors affecting therapeutic effect and the deficiencies of researches about UCP in the treatment of glaucoma were reviewed in this article.
孟素坤,许珂,张纯. 超声睫状体成形术治疗青光眼研究进展[J]. 中华实验眼科杂志,2022,40(04):357-360.
DOI:10.3760/cma.j.cn115989-20200213-00069版权归中华医学会所有。
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