Kano K, Kuwayama Y, Mizoue S, Ito N
Department of Ophthalmology, Osaka Koseinenkin Hospital, Japan.
Nippon Ganka Gakkai Zasshi. 1999 Aug;103(8):612-6.
Selective laser trabeculoplasty (SLT) is a new laser procedure using a frequency-doubled Q-switched Nd: YAG laser (wavelength: 532 mm). The laser parameters are set to selectively target pigmented trabecular meshwork (TM) cells without coagulative damage to the TM structure or non-pigmented cells. We investigated the safety and efficacy of SLT in lowering intraocular pressure (IOP).
Sixty-seven eyes of 67 patients with uncontrolled open angle glaucoma were treated with the Coherent Selecta 7000 (Coherent Inc., Palo Alto, CA). Nineteen of 67 patients had previously received argon laser trabeculoplasty (ALT). A total of approximately 60 non-overlapping spots were placed over 180 degrees of the TM ranging from 0.5 to 1.0 mJ per pulse. The maximum energy level at which no bubble formation was observed determined choice.
The average preoperative IOP was 22.4 mmHg. Six months after the operation, mean IOP reduction was 4.4 mmHg, and mean outflow pressure (OP) reduction was 38.1%. One month after the operation 68.7% of patients responded to treatment with an OP reduction of at least 20% ("responders"). Transient IOP elevation of 5 mmHg or greater was seen in 25.4% of patients. The success rate at 6 months after operation was 64.6% for all patients (67 eyes) and 78.2% for the responders (46 eyes). An analysis using a Cox proportional hazard model showed that a low preoperative IOP was the significant determinant for success, and the hazard ratio for the IOP increase of 5 mmHg was 2.12. Other factors such as age, gender, past history of ALT, and goniopigment were not significantly related to success.
SLT appears to be a safe and effective way to lower IOP.
选择性激光小梁成形术（SLT）是一种使用倍频调Q开关Nd:YAG激光（波长：532nm）的新型激光手术。激光参数设置为选择性地靶向色素性小梁网（TM）细胞，而不对TM结构或非色素性细胞造成凝固性损伤。我们研究了SLT降低眼压（IOP）的安全性和有效性。
67例开角型青光眼控制不佳的患者的67只眼接受了Coherent Selecta 7000（Coherent公司，加利福尼亚州帕洛阿尔托）治疗。67例患者中有19例曾接受过氩激光小梁成形术（ALT）。在TM的180度范围内共放置约60个不重叠的光斑，每个脉冲能量为0.5至1.0mJ。根据未观察到气泡形成的最大能量水平来确定选择。
术前平均IOP为22.4mmHg。术后6个月，平均IOP降低4.4mmHg，平均流出压（OP）降低38.1%。术后1个月，68.7%的患者对治疗有反应，OP降低至少20%（“有反应者”）。25.4%的患者出现了5mmHg或更高的短暂IOP升高。所有患者（67只眼）术后6个月的成功率为64.6%，有反应者（46只眼）为78.2%。使用Cox比例风险模型分析显示，术前低IOP是成功的重要决定因素，IOP升高5mmHg的风险比为2.12。年龄、性别、既往ALT病史和房角色素沉着等其他因素与成功无显著相关性。
SLT似乎是一种降低IOP的安全有效的方法。
