Lai Jimmy S M, Tham Clement C Y, Chan Jonathan C H, Lam Dennis S C
Department of Ophthalmology, United Christian Hospital, Kowloon, Hong Kong.
J Glaucoma. 2003 Aug;12(4):360-4. doi: 10.1097/00061198-200308000-00011.
To evaluate the efficacy and safety of diode laser transscleral cyclophotocoagulation in the treatment of chronic angle-closure glaucoma.
A prospective, non-comparative interventional pilot study was conducted. Fourteen eyes of 14 Chinese patients with chronic angle-closure glaucoma whose intraocular pressures were greater than 21 mm Hg on medications were treated with diode laser transscleral cyclophotocoagulation using the G-probe at the United Christian Hospital between February 2000 and May 2001. The inferior 270 degrees quadrant (from 2 to 11 o'clock for right eye and from 1 to 10 o'clock for left eye) was treated and the patients were followed up regularly. The initial laser energy was set at 2,000 mWatt with a duration of 2 seconds. The post-treatment anti-glaucoma medications were adjusted according to the intraocular pressure. If medications failed to lower the intraocular pressure to below 21 mm Hg, cyclophotocoagulation to the same inferior 270 degrees quadrant was repeated.
All patients completed a 12-month follow-up period. The total success rate defined as IOP < 21 mm Hg with or without medication(s) was 85.7% at 1 year of follow-up review. The mean +/- SD intraocular pressure decreased from pre-treatment level of 36.9 +/- 11.7 mm Hg to 18.9 +/- 6.5 mm Hg at 1 year after treatment. The difference was statistically significant (P < 0.001) (Paired t test). The mean +/- SD number of IOP-lowering eyedrops was significantly reduced from 1.9 +/- 0.7 before cyclophotocoagulation to 0.4 +/- 0.8 at 1 year after treatment (P = 0.0002) (Paired t test). Two eyes required repeat treatment. Seven eyes (50%) had atonic pupil following the laser treatment.
Diode laser transscleral cyclophotocoagulation is effective in lowering the intraocular pressure in chronic angle-closure glaucoma and its effect lasts for at least 1 year.
评估二极管激光经巩膜睫状体光凝术治疗慢性闭角型青光眼的疗效和安全性。
进行了一项前瞻性、非对照性干预性初步研究。2000年2月至2001年5月期间，在联合医院对14例患有慢性闭角型青光眼且使用药物后眼压大于21mmHg的中国患者的14只眼睛，使用G探头进行二极管激光经巩膜睫状体光凝术治疗。治疗下方270度象限（右眼从2点至11点，左眼从1点至10点），并对患者进行定期随访。初始激光能量设定为2000毫瓦，持续时间为2秒。治疗后根据眼压调整抗青光眼药物。如果药物未能将眼压降至21mmHg以下，则对同一下方270度象限重复进行睫状体光凝术。
所有患者均完成了12个月的随访期。随访1年时，定义为眼压<21mmHg（无论是否使用药物）的总成功率为85.7%。治疗1年后，眼压均值±标准差从治疗前的36.9±11.7mmHg降至18.9±6.5mmHg。差异具有统计学意义（P<0.001）（配对t检验）。眼压降低滴眼液的平均使用数量±标准差从睫状体光凝术前的1.9±0.7显著减少至治疗后1年的0.4±0.8（P = 0.0002）（配对t检验）。2只眼睛需要重复治疗。7只眼睛（50%）在激光治疗后出现瞳孔无反应。
二极管激光经巩膜睫状体光凝术在降低慢性闭角型青光眼眼压方面有效，且其效果至少持续1年。
