综述
ENGLISH ABSTRACT
超声睫状体成形术治疗青光眼研究进展
孟素坤
许珂 [综述]
张纯 [综述]
作者及单位信息
·
DOI: 10.3760/cma.j.cn115989-20200213-00069
Research progress in ultrasound cycloplasty for the treatment of glaucoma
Meng Sukun
Xu Ke
Zhang Chun
Authors Info & Affiliations
Meng Sukun
Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China
Xu Ke
Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China
Zhang Chun
Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China
·
DOI: 10.3760/cma.j.cn115989-20200213-00069
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摘要

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。

青光眼;难治性青光眼;睫状体;手术;超声睫状体成形术
ABSTRACT

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.

Glaucoma;Refractory glaucoma;Ciliary body;Surgery;Ultrasound cycloplasty
Zhang Chun, Email: mocdef.oabohay1cgnahZ
引用本文

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

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青光眼是全球首位不可逆性致盲眼病,2013年全球青光眼患者(40~80岁)约有6 430万,2040年将增加至1.118亿 [ 1 ]。治疗青光眼的主要方法是降低眼压,通常先使用降眼压滴眼液,当药物治疗不足以稳定病情时,则考虑行激光或手术。睫状体激光光凝术是一种常用的睫状体破坏手术,其原理是使用激光能量破坏睫状体,减少房水生成,从而降低眼压,但该手术有术眼疼痛感强、无法定量等缺点。最近,一种新型装置使用微型换能器产生高强度聚焦超声(high-intensity focused ultrasound,HIFU)使睫状体凝固,称为超声睫状体成形术(ultrasound cycloplasty,UCP) [ 2 ]。目前UCP的治疗指征主要为难治性青光眼,可以安全、有效地降低眼压,并发症较少,患者疼痛感轻,成为青光眼治疗领域的新选择。本文就UCP治疗青光眼的适应证、手术方法、注意事项、作用机制、有效性、安全性及影响治疗效果的因素等进行综述,以期为其临床治疗和研究提供参考。
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备注信息
A
张纯,Email: mocdef.oabohay1cgnahZ
B
所有作者均声明不存在利益冲突
C
国家自然科学基金项目 (81970798)
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