[选择性激光小梁成形术治疗原发性开角型青光眼]

[Selective laser trabeculoplasty in the treatment of primary open-angle glaucoma].

作者信息

Qian Shao-Hong, Sun Xing-Huai

机构信息

Eye & ENT Hospital, Fudan University, Shanghai 200031, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2007 Jan 9;87(2):118-20.

PMID:17418020

Abstract

OBJECTIVE

To investigate the efficacy and safety of selective laser trabeculoplasty (SLT) in the treatment of primary open angle glaucoma (POAG).

METHODS

In a prospective non-randomized clinical study, 63 patients (85 eyes) with POAG and medically uncontrolled intraocular pressure (IOP) underwent SLT. A total of 50 +/- 5 adjacent but nonoverlapping spots were placed over inferior 180 degrees of the trabecular meshwork using a 532 nm, Q-switched, Nd: YAG laser at energy levels ranging from 0.6 - 1.8 mJ per pulse. After SLT, the eyes continued to receive the identical drug regimen. All patients were observed before and 1, 2 hours, 1, 7 and 14 days, and 1, 2, 3, 6, 9, 12, 18, and 24 months after the treatment.

RESULTS

The average pre-operative IOP was (25 +/- 4) mm Hg (1 mm Hg = 0.133 kPa). The mean IOP reduction from baseline were 8.1 mm Hg (32.0%) 1 day after the SLT, 5.6 mm Hg (22.1%) 7 days after the SLT, 4.7 mm Hg (18.6%) 14 days after the SLT, 5.5 mm Hg (21.7%) 1 month after the SLT, 5.1 mm Hg (20.2%) 2 months after the SLT, 5.9 mm Hg (23.3%) 3 months after the SLT, 5.2 mm Hg (20.6%) 6 months after the SLT, 4.0 mm Hg (15.8%) 9 months after the SLT, 4.2 mm Hg (16.6%) 12 months after the SLT, 3.8 mm Hg (15.0%) 18 months after the SLT, and 3.3 mm Hg (13.0%) 24 months after the SLT (P < 0.01 or 0.05). Adverse reactions were minimal, including conjunctival injection, mild anterior chamber reaction, and transient pressure spike.

CONCLUSION

SLT is a safe, and effective method of reducing IOP in POAG patients.

摘要

目的

探讨选择性激光小梁成形术（SLT）治疗原发性开角型青光眼（POAG）的疗效和安全性。

方法

在一项前瞻性非随机临床研究中，63例（85只眼）POAG且眼压经药物治疗控制不佳的患者接受了SLT。使用532nm调Q钕:钇铝石榴石激光，在小梁网下方180度范围内共放置50±5个相邻但不重叠的光斑，每个脉冲能量水平为0.6 - 1.8mJ。SLT术后，这些眼睛继续接受相同的药物治疗方案。所有患者在治疗前、治疗后1、2小时、1、7和14天以及1、2、3、6、9、12、18和24个月进行观察。

结果

术前平均眼压为（25±4）mmHg（1mmHg = 0.133kPa）。SLT术后1天眼压较基线平均降低8.1mmHg（32.0%），术后7天降低5.6mmHg（22.1%），术后14天降低4.7mmHg（18.6%），术后1个月降低5.5mmHg（21.7%），术后2个月降低5.1mmHg（20.2%），术后3个月降低5.9mmHg（23.3%），术后6个月降低5.2mmHg（20.6%），术后9个月降低4.0mmHg（15.8%），术后12个月降低4.2mmHg（16.6%），术后18个月降低3.8mmHg（15.0%），术后24个月降低3.3mmHg（13.0%）（P < 0.01或0.05）。不良反应轻微，包括结膜充血、轻度前房反应和短暂的眼压峰值。