Beuerle S, Philippin H, Funk J
Augenklinik, Universität Freiburg, Killianstrasse 5, 79106 Freiburg.
Ophthalmologe. 2006 Jul;103(7):605-8. doi: 10.1007/s00347-006-1360-5.
The surgical therapy of glaucoma aims at an effective IOP lowering as well as at a long-term effect with few complications. The previous gold standard of combined surgery consisted of cataract surgery and trabeculectomy. The combination of cataract surgery and Erb:YAG goniotomy might be an alternative.
A total of 17 eyes were treated with combined Erb:YAG goniotomy. The control group underwent combined trabeculectomy and consisted of 23 eyes. The mean follow-up was 5 years and assessed IOP lowering, visual acuity, antiglaucomatous drugs, and complications.
After 5 years the IOP of the Erb:YAG group decreased from 23.3 to 16.9 mmHg. In the control group, the IOP was reduced from 23.3 mmHg to 15.8 mmHg. Two eyes of the Erb:YAG group needed further surgery due to insufficient IOP control, whereas in the control group ten repeat procedures were necessary.
The small number of complications in combination with a sustainable IOP-lowering effect seems to be an advantage in the long-term treatment of glaucoma. We hope that this can be transferred to the new excimer laser trabeculotomy since the 3-year results are already comparable to the Erb:YAG laser.
青光眼的手术治疗旨在有效降低眼压，并实现长期效果且并发症少。先前联合手术的金标准是白内障手术和小梁切除术。白内障手术与铒激光房角切开术相结合可能是一种替代方法。
共有17只眼接受了铒激光房角切开术联合治疗。对照组接受小梁切除术联合治疗，共23只眼。平均随访时间为5年，评估眼压降低情况、视力、抗青光眼药物使用情况及并发症。
5年后，铒激光组的眼压从23.3 mmHg降至16.9 mmHg。对照组的眼压从23.3 mmHg降至15.8 mmHg。铒激光组有2只眼因眼压控制不佳需要进一步手术，而对照组则需要进行10次重复手术。
并发症数量少且眼压降低效果可持续，这似乎是青光眼长期治疗的一个优势。我们希望这可以应用于新的准分子激光小梁切开术，因为3年的结果已经与铒激光相当。
