睫状体分泌功能减弱性手术在青光眼治疗中的进展

doi:10.6040/j.issn.1673-3770.0.2021.323

摘要/Abstract

摘要： 睫状体分泌功能减弱性手术是通过各种方式破坏睫状体来减少房水生成从而达到降低眼压、治疗青光眼的目的。既往由于睫状体分泌功能减弱性手术的并发症较多且比较严重,加之不可预测的剂量-效应关系,被认为是降低眼压、控制青光眼的最后手段。随着医疗技术的发展,睫状体分泌功能减弱性手术有了较大的改进,其并发症明显减少且较轻微,成为抗青光眼手术史的一大进步。论文主要介绍睫状体透热术、睫状体冷冻术、睫状体光凝术、睫状体光动力疗法、高强度聚焦超声睫状体成形术等多种睫状体分泌功能减弱性手术各自的特点及在青光眼治疗中的应用和进展。

关键词: 睫状体透热术, 睫状体冷冻术, 睫状体光凝术, 睫状体光动力疗法, 高强度聚焦超声睫状体成形术, 青光眼

Abstract: Cyclodestruction is a kind of anti-glaucoma surgery that reduces intraocular pressure by damaging ciliary body to supress aqueous humor production in various ways, including cyclodiathermy, cyclocryotherapy, cyclophotocoagulation, photodynamic therapy of the ciliary body, and high-intensity focused ultrasound cycloplasty. In the past, it was considered as the last means to treat glaucoma and reduce intraocular pressure because of it's severe and serious complications and an unpredictable dose-effect relationship. With the development of medical technology, cyclodestructive surgeries have been greatly improved, intraocular pressure reduction become more effective, and the complications are significantly reduced and mild. It is a great progress in the history of anti-glaucoma surgery. This article introduces the characteristics, application, and progress of each type of cyclodestructive surgries.

Key words: Cyclodiathermy, Cyclocryotherapy, Cyclophotocoagulation, Photodynamic therapy of the ciliary body, High-intensity focused ultrasound cycloplasty, Glaucoma

中图分类号:

R775

刘乐乐,孔香云综述申家泉审校. 睫状体分泌功能减弱性手术在青光眼治疗中的进展[J]. 山东大学耳鼻喉眼学报, 2022, 36(6): 123-128.

LIU Lele, KONG XiangyunOverview,SHEN JiaquanGuidance. Progress of cyclodestructive surgeries for treating glaucoma[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(6): 123-128.

参考文献

[1] 陶钰, 张士玺, 柴雪荣, 等. 青光眼患者生存质量及其影响因素的临床研究[J]. 山东大学耳鼻喉眼学报, 2014, 28(2): 84-86. doi: 10.6040/.j.issn.1673-3770.0.2014.037. TAO Yu, ZHANG Shixi, CHAI Xuerong, et al. Clinical study on glaucoma patients' quality of life and related factors[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2014, 28(2): 84-86. doi:10.6040/j.issn.1673-3770.0.2014.037.
[2] Jurjevic D, Funk J, Töteberg-Harms M. Zyklodestruktive Verfahren zur Senkung des Augeninnendrucks-eine übersicht[J]. Klin Monatsbl Augenheilkd, 2019, 236(1): 63-68. doi:10.1055/s-0043-105271.
[3] Abdullatif AM, Ahmed El-Saied HM. Various modalities of cyclodestruction in non-refractory glaucoma: a comparative study[J]. Int Ophthalmol, 2021, 41(10):3313-3323. doi:10.1007/s10792-021-01893-z.
[4] Vogt A. Cyclodiathermypuncture in cases of glaucoma[J]. Br J Ophthalmol. 1940, 24(6): 288-297. doi:10.1136/bjo.24.6.288.
[5] Urrets-zavalia A Jr, Urrets-zavalia A. Nonperforating cyclodiathermy in the treatment of glaucoma; diathermia retrociliaris[J]. Am J Ophthalmol, 1953, 36(2): 203-217. doi:10.1016/0002-9394(53)90899-x.
[6] Bietti G. Surgical intervention on the ciliary body[J]. J Am Med Assoc, 1950, 142(12): 889. doi:10.1001/jama.1950.02910300027006.
[7] Dastiridou AI, Katsanos A, Denis P, et al. Cyclodestructive procedures in glaucoma: a review of current and emerging options[J]. Adv Ther, 2018, 35(12): 2103-2127. doi:10.1007/s12325-018-0837-3.
[8] Caprioli J, Strang SL, Spaeth GL, et al. Cyclocryotherapy in the treatment of advanced Glaucoma[J]. Ophthalmology, 1985, 92(7): 947-954. doi:10.1016/s0161-6420(85)33951-9.
[9] 郭娟. 睫状体冷凝手术治疗各型晚期青光眼[J]. 眼外伤职业眼病杂志, 2003(10): 662-663. doi: CNKI:SUN:YWSZ.0.2003-10-008. GUO Juan. Treatment of late-stage Glaucoma by cyclocryotherapy[J]. Chin J Ocular Trauma Occup Eye Dis Ophthalmic Surg, 2003(10): 662-663. doi: CNKI:SUN:YWSZ.0.2003-10-008.
[10] Devenyi RG, Trope GE, Hunter WH, et al. Neodymium: YAG transscleral cyclocoagulation in human eyes[J]. Ophthalmology, 1987, 94(12):1519-1522. doi:10.1016/s0161-6420(87)33252-x.
[11] Zimmerman TJ, Worthen DM, Wickham G. Argon laser photocoagulation of ciliary processes and pigmented pupillary membrane in man[J]. Invest Ophthalmol, 1973, 12(8): 622-623. doi: 10.1016/0014-4835(73)90009-2.
[12] Devenyi RG, Trope GE, Hunter WH, et al. Neodymium: YAG transscleral cyclocoagulation in human eyes[J]. Ophthalmology. 1987, 94(12): 1519-1522. doi:10.1016/s0161-6420(87)33252-x.
[13] Hennis HL, Stewart WC. Semiconductor diode laser transscleral cyclophotocoagulation in patients with Glaucoma[J]. Am J Ophthalmol, 1992, 113(1): 81-85. doi:10.1016/s0002-9394(14)75758-7.
[14] Iliev ME, Gerber S. Long-term outcome of trans-scleral diode laser cyclophotocoagulation in refractory Glaucoma[J]. Br J Ophthalmol, 2007, 91(12): 1631-1635. doi:10.1136/bjo.2007.116533.
[15] 侯旭, 武静, 周健, 等. 以个体化透巩膜睫状体光凝为首选术式治疗钝挫伤后青光眼眼压失控的安全性和有效性[J]. 临床医学研究与实践, 2020, 5(31): 7-10. doi:10.19347/j.cnki.2096-1413.202031002. HOU Xu, WU Jing, ZHOU Jian, et al. Safety and effectiveness of individualized transscleral cyclophotocoagulation as the initial surgical intervention for medically uncontrolled intraocular pressure in Glaucoma after blunt trauma[J]. Clin Res Pract, 2020, 5(31): 7-10. doi:10.19347/j.cnki.2096-1413.202031002.
[16] Chiam PJ, Sung VCT. The outcome of transscleral cyclophotocoagulation for the management of acute angle closure[J]. Eur J Ophthalmol, 2018, 28(2): 188-192. doi:10.5301/ejo.5001026.
[17] Abdullatif AM, Ahmed El-Saied HM. Various modalities of cyclodestruction in non-refractory glaucoma: a comparative study[J]. Int Ophthalmol, 2021, 41(10): 3313-3323. doi:10.1007/s10792-021-01893-z.
[18] 田丹丹, 李晶明, 宋艳敏, 等. 巩膜睫状体光凝术治疗恶性青光眼睫状环阻滞解除后高眼压[J]. 国际眼科杂志, 2021, 21(2): 348-350. doi: 10.3980/j.issn.1672-5123.2021.2.32. TIAN Dandan, LI Jingming, SONG Yanmin, et al. Clinical observation of high intraocular pressure after the removal of ciliary ring block in the treatment of malignant Glaucoma by scleral cyclophotocoagulation[J]. Int Eye Sci, 2021, 21(2): 348-350. doi: 10.3980/j.issn.1672-5123.2021.2.32.
[19] Sieminski SF, Varikuti VNV, Shah P, et al. Response to: outcomes of micropulse transscleral cyclophotocoagulation in eyes with good central vision[J]. J Glaucoma, 2020, 29(3): e16-e17. doi:10.1097/IJG.0000000000001437.
[20] Kosoko O, Gaasterland DE, Pollack IP, et al. Long-term outcome of initial ciliary ablation with contact diode laser transscleral cyclophotocoagulation for severe glaucoma. The Diode Laser Ciliary Ablation Study Group[J]. Ophthalmology, 1996, 103(8): 1294-1302. doi:10.1016/s0161-6420(96)30508-3.
[21] Uram M. Ophthalmic laser microendoscope ciliary process ablation in the management of neovascular Glaucoma[J]. Ophthalmology, 1992, 99(12): 1823-1828. doi:10.1016/s0161-6420(92)31718-x.
[22] Pantcheva MB, Kahook MY, Schuman JS, et al. Comparison of acute structural and histopathological changes of the porcine ciliary processes after endoscopic cyclophotocoagulation and transscleral cyclophotocoagulation[J]. Clin Exp Ophthalmol, 2007, 35(3): 270-274. doi:10.1111/j.1442-9071.2006.01415.x.
[23] Yu MB, Huang SS, Ge J, et al. The clinical study of endoscopic cyclophotocoagulation on the management of refractory glaucoma[J]. Zhonghua Yan Ke Za Zhi, 2006, 42(1): 27-31. doi: 10.1109/ECTC.2008.4550264.
[24] Wicek MP, Miszczuk T, Lipiński A, et al. Safety and efficacy of isolated endoscopic cyclophotocoagulation in pseudophakic patients with primary open-angle glaucoma-12-month follow-up[J]. J Clin Med, 2021, 10(18): 4212. doi:10.3390/jcm10184212.
[25] Feinstein MA, Lee JH, Amoozgar B, et al. Comparison between pars Plana and anterior endoscopic cyclophotocoagulation for the treatment of Glaucoma[J]. Clin Exp Ophthalmol, 2019, 47(6): 766-773. doi:10.1111/ceo.13501.
[26] Waldo LG, Julio HQ, Jennifer CV, et al. Combined technique for the application of micropulse cyclophotocoagulation in patients with uncontrolled glaucoma: cyclo mix[J]. J Curr Glaucoma Pract, 2020, 14(3): 93-97. doi:10.5005/jp-journals-10078-1289.
[27] Kuchar S, Moster MR, Reamer CB, et al. Treatment outcomes of micropulse transscleral cyclophotocoagulation in advanced Glaucoma[J]. Lasers Med Sci, 2016, 31(2): 393-396. doi:10.1007/s10103-015-1856-9.
[28] Fea AM, Laffi GL, Martini E, et al. Effectiveness of MicroShunt in patients with primary open-angle and pseudoexfoliative glaucoma: a retrospective European multicenter study[J]. Ophthalmol Glaucoma, 2021, 5(2):210-218. doi:10.1016/j.ogla.2021.08.005.
[29] Nguyen AT, Maslin J, Noecker RJ. Early results of micropulse transscleral cyclophotocoagulation for the treatment of Glaucoma[J]. Eur J Ophthalmol, 2020, 30(4): 700-705. doi:10.1177/1120672119839303.
[30] Hill RA, Esterowitz T, Ryan J, et al. Photodynamic laser cyclodestruction with chloroaluminum sulfonated phthalocyanine(CASPc)or Photofrin(PII)vs. Nd: YAG laser cyclodestruction in a pigmented rabbit model[J]. Lasers Surg Med, 1995, 17(2): 166-171. doi:10.1002/lsm.1900170205.
[31] Charisis SK, Detorakis ET, Vitanova VS, et al. Contact transcleral photodynamic cyclo-suppression in human eyes: a feasibility study[J]. Can J Ophthalmol, 2011, 46(2): 196-198. doi:10.3129/i10-109.
[32] Lynn JG, Zwemer RL, Chick AJ, et al. A new method for the generation and use of focused ultrasound in experimental biology[J]. J Gen Physiol, 1942, 26(2): 179-193. doi:10.1085/jgp.26.2.179.
[33] Coleman DJ, Lizzi FL, Driller J, et al. Therapeutic ultrasound in the treatment of glaucoma II. Clinical applications[J]. Ophthalmology, 1985, 92(3):347-353. doi: 10.1016/S0161-6420(85)34028-9.
[34] Aptel F, Charrel T, Palazzi X, et al. Histologic effects of a new device for high-intensity focused ultrasound cyclocoagulation[J]. Invest Ophthalmol Vis Sci, 2010, 51(10): 5092-5098. doi:10.1167/iovs.09-5135.
[35] Mastropasqua R, Agnifili L, Fasanella V, et al. Uveo-scleral outflow pathways after ultrasonic cyclocoagulation in refractory glaucoma: an anterior segment optical coherence tomography and in vivo confocal study[J]. Br J Ophthalmol, 2016, 100(12): 1668-1675. doi:10.1136/bjophthalmol-2015-308069.
[36] Morais Sarmento T, Figueiredo R, Garrido J, et al. Transient choroidal detachment after ultrasonic circular cyclocoagulation[J]. BMJ Case Rep, 2019, 12(10): e231677. doi:10.1136/bcr-2019-231677.
[37] 牟大鹏, 唐炘, 安文在, 等. 超声睫状体成形术治疗难治性青光眼半年随访效果的临床研究[J]. 中华眼科医学杂志(电子版), 2019, 9(6): 366-371. doi: CNKI:SUN:ZHYB.0.2019-06-008. MOU Dapeng, TANG Xin, AN Wenzai, et al. Half-year follow-up of ultrasound cycloplasty for refractory Glaucoma[J]. Chin J Ophthalmol Med Electron Ed, 2019, 9(6): 366-371. doi: CNKI:SUN:ZHYB.0.2019-06-008.
[38] 夏冉, 姜波, 王明睿, 等. 超声睫状体成形术治疗新生血管性青光眼短期疗效观察[J]. 临床眼科杂志, 2021, 29(2): 157-160. doi: 10.3969/j.issn.1006-8422.2021.02.014. XIA Ran, JIANG Bo, WANG Mingrui, et al. Therapeutic effect of ultrasound cycloplasty on neovascular Glaucoma[J]. J Clin Ophthalmol, 2021, 29(2): 157-160. doi: 10.3969/j.issn.1006-8422.2021.02.014.
[39] Giannaccare G, Pellegrini M, Bernabei F, et al. A 2-year prospective multicenter study of ultrasound cyclo plasty for Glaucoma[J]. Sci Rep, 2021, 11(1): 12647. doi:10.1038/s41598-021-92233-9.
[40] Rouland JF, Aptel F. Efficacy and safety of ultrasound cycloplasty for refractory glaucoma: a 3-year study[J]. J Glaucoma, 2021, 30(5): 428-435. doi:10.1097/IJG.0000000000001796.
[41] De Gregorio A, Pedrotti E, Stevan G, et al. Safety and efficacy of multiple cyclocoagulation of ciliary bodies by high-intensity focused ultrasound in patients with Glaucoma[J]. Graefes Arch Clin Exp Ophthalmol, 2017, 255(12): 2429-2435. doi:10.1007/s00417-017-3817-4.
[42] Hu D, Tu S, Zuo C, et al. Short-term observation of ultrasonic cyclocoagulation in Chinese patients with end-stage refractory glaucoma: a retrospective study[J]. J Ophthalmol, 2018: 4950318. doi:10.1155/2018/4950318.
[43] Yu QL, Liang Y, Ji FF, et al. Comparison of ultrasound cycloplasty and transscleral cyclophotocoagulation for refractory Glaucoma in Chinese population[J]. BMC Ophthalmol, 2020, 20(1): 387. doi:10.1186/s12886-020-01655-y.

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