Mermoud A, Karlen M E, Schnyder C C, Sickenberg M, Chiou A G, Hédiguer S E, Sanchez E
Hôpital Ophtalmique Jules Gonin, University of Lausanne, Switzerland.
Ophthalmic Surg Lasers. 1999 Feb;30(2):120-5.
To study the need, the safety and the success rate of Nd:Yag goniopuncture in eyes that underwent deep sclerectomy with collagen implant.
The first 100 patients that underwent deep sclerectomy with collagen implant were prospectively followed. Deep sclerectomy with collagen implant is a non-penetrating filtering surgery which allows filtration of aqueous from the anterior chamber to the subconjunctival space through a remaining trabeculo-Descemet's membrane without opening the anterior chamber. Goniopunctures with Nd:Yag laser were performed at the site of surgery when the filtration through the trabeculo-Descemet's membrane was considered to be insufficient with elevated intraocular pressure. The laser treatment was performed using a Lasag 15 gonioscopy contact lens (CGA1). Goniopunctures were performed using the free-running Q-switched mode with an energy ranging from 2 to 4 mJ.
Of 100 patients who underwent deep sclerectomy with collagen implant, goniopunctures with Nd:Yag laser were performed in 41 patients (41%). The mean time between deep sclerectomy with collagen implant and goniopuncture was 9.9 months +/-1.2 months (+/-SE). The mean IOP before laser treatment was 22.2 mm +/-7.0 mm Hg and decreased to 12.5 mm +/-5.8 mm Hg immediately after laser treatment and remained stable for the next 2 years of follow-up. The immediate success rate of goniopuncture was 83%. Choroidal detachment occurred in two patients (5%).
Nd:Yag goniopuncture is an efficient and safe treatment for low filtration through the trabeculo-Descemet's membrane after deep sclerectomy with collagen implant.
研究接受胶原植入物深层巩膜切除术的眼睛进行Nd:Yag前房角穿刺的必要性、安全性及成功率。
对首批100例行胶原植入物深层巩膜切除术的患者进行前瞻性随访。胶原植入物深层巩膜切除术是一种非穿透性滤过手术，可使房水从前房通过残留的小梁-Descemet膜滤至结膜下间隙，而不打开前房。当经小梁-Descemet膜的滤过被认为不足且眼压升高时，在手术部位用Nd:Yag激光进行前房角穿刺。激光治疗使用Lasag 15前房角镜接触镜（CGA1）。前房角穿刺采用自由运行的Q开关模式，能量范围为2至4 mJ。
100例行胶原植入物深层巩膜切除术的患者中，41例（41%）接受了Nd:Yag激光前房角穿刺。胶原植入物深层巩膜切除术与前房角穿刺之间的平均时间为9.9个月±1.2个月（±标准误）。激光治疗前的平均眼压为22.2 mmHg±7.0 mmHg，激光治疗后立即降至12.5 mmHg±5.8 mmHg，并在接下来的2年随访中保持稳定。前房角穿刺的即刻成功率为83%。2例患者（5%）发生脉络膜脱离。
Nd:Yag前房角穿刺是胶原植入物深层巩膜切除术后经小梁-Descemet膜低滤过的一种有效且安全的治疗方法。
