摘要目的:评价经巩膜睫状体光凝术(TCP)治疗难治性青光眼的效果。方法:回顾性研究。对北京爱尔英智眼科医院2017年7月至2018年12月行TCP治疗的难治性青光眼73例(81只眼)的临床资料进行分析。观察手术前后眼压、降眼压药物使用种类、术中光凝情况和并发症的发生。术后随访6个月。结果:术前眼压(35.0±8.8)mmHg(1mmHg＝0.133 kPa)；术前使用降眼压药物3(3，4)种；术中光凝能量(2 027.00±235.88)mW、光凝范围238.0°±44.7°、光凝点数(31.00±7.17)个；术后1 d眼压为(18.67±7.13)mmHg，术后1个月眼压(18.50±8.28) mmHg，术后3个月眼压(19.25±6.79)mmHg，术前与术后各时间点眼压差异均有统计学意义( t＝14.496、12.775、11.277、11.802，均 P<0.05)；术后使用降眼压药物0(0，1)种；术后视力不变65只眼(80.2%)；各类型难治性青光眼手术成功率70.0%～87.5%；术后长期低眼压2只眼，眼球萎缩2只眼。 结论:TCP可有效治疗难治性青光眼，对继发性青光眼效果优于原发性青光眼。

abstractsObjective:To evaluate the efficacy of transscleral cyclophotocoagulation (TCP) for the treatment of refractory glaucoma.Methods:This was a retrospective study. The clinical data of 81 eyes of 73 cases with refractory glaucoma who underwent TCP treatment from Jul. 2017 to Dec. 2018 in Beijing Aier-Intech Eye Hospital were analyzed. The preoperative and postoperative IOP, kinds of anti-IOP drugs, intraoperative photocoagulation and occurrence of complications were observed. The follow-up time was 6 months after operation.Results:The intraocular pressure was (35.0±8.8) mmHg before operation (1 mmHg=0.133 kPa). The preoperative kinds of anti-IOP drugs was 3(3, 4)kinds. The photocoagulation energy was (2 027.00±235.88) mW and the cyclophotocoagulation range was 238.0°±44.7°.The number of cyclophotocoagulation points was 31.00±7.17. The intraocular pressure was 6-38 mmHg at 1 day postoperatively, with an average of (18.67±7.13) mmHg. The intraocular pressure was (18.50±8.28) mmHg at 1 month after operation, and the intraocular pressure was (19.25±6.79) mmHg at 3 months after operation. The difference between preoperative and postoperative intraocular pressure at each time point was statistically significant( t=14.496, 12.775, 11.277, 11.802; all P<0.05). The postoperative kinds of anti-IOP drugs was 0 (0, 1)kinds. The postoperative visual acuity was unchanged in 65 eyes (80.2%). The successful rate of all types of refractory glaucoma was 70.0% to 87.5%. Complications included 2 eyes of long-term low intraocular pressure and 2 eyes of postoperative eyeball atrophy. Conclusion:TCP is effective for the treatment of refractory glaucoma. The efficacy of the secondary glaucoma is better than that of the primary glaucoma.