Pajic Bojan, Pallas Grigoris, Gerding Heinrich, Böhnke Matthias
Department of Ophthalmology, Klinik Pallas, 4600 Olten, Switzerland.
Graefes Arch Clin Exp Ophthalmol. 2006 Jan;244(1):22-7. doi: 10.1007/s00417-005-0041-4. Epub 2005 Jul 19.
It was the aim of this study to investigate the efficacy, longevity, and safety of a new ab interno intervention for the treatment of primary open-angle glaucoma (POAG).
The previously described method of radiofrequency-mediated "sclerothalamotomy ab interno" was applied in 53 eyes of consecutive patients with POAG between April 2002 and July 2002. Average preoperative intraocular pressure (IOP) was 25.6+/-2.3 mmHg (range 18-48 mmHg). Sclerothalamotomies were carried out with a custom-made high-frequency dissection 19 G probe (tip 0.3 x 1 mm) applying bipolar current with a frequency of 500 kHz (tip temperature 130 degrees C).
After a follow-up period of 24 months, the average IOP was 15.0+/-1.6 mmHg (range 11-20 mmHg) (p<0.005). The average number of topical agents was 2.6+/-1.0 (range 1-5) preoperatively. Twenty-four months after surgery such agents were used in only five (9.6%) eyes and the average was 0.21+/-0.53 (range 0-2). Transient IOP elevation was observed in 12 of 53 eyes (22.6%) postoperatively. In all cases elevated IOP could efficiently be controlled with topical medication. In general, IOP dropped continuously over the course of the 6 months following surgery and then remained constant.
This study indicates that sclerothalamotomy ab interno is a safe and efficient surgical method for the treatment of POAG. Long-term results clearly demonstrate the longevity of IOP reduction.
本研究旨在探讨一种新的内路干预方法治疗原发性开角型青光眼（POAG）的疗效、持久性和安全性。
2002年4月至2002年7月期间，对53例连续性POAG患者的眼睛应用先前描述的射频介导的“内路巩膜丘脑切开术”方法。术前平均眼压（IOP）为25.6±2.3 mmHg（范围18 - 48 mmHg）。使用定制的高频解剖19G探头（尖端0.3×1 mm）进行巩膜丘脑切开术，施加频率为500 kHz的双极电流（尖端温度130摄氏度）。
随访24个月后，平均眼压为15.0±1.6 mmHg（范围11 - 20 mmHg）（p<0.005）。术前局部用药的平均数量为2.6±1.0（范围1 - 5）。术后24个月，仅5只（9.6%）眼睛使用此类药物，平均为0.21±0.53（范围0 - 2）。术后53只眼中有12只（22.6%）观察到短暂眼压升高。在所有病例中，升高的眼压均可通过局部用药有效控制。一般来说，眼压在术后6个月内持续下降，然后保持稳定。
本研究表明内路巩膜丘脑切开术是一种治疗POAG的安全有效的手术方法。长期结果清楚地证明了眼压降低的持久性。
