Wierzbowska Joanna, Stankiewicz Andrzej, Romańska Łucja
Z Kliniki Okulistycznej Wojskowego Instytutu Medycznego, Warszawie.
Klin Oczna. 2008;110(7-9):287-91.
To evaluate the efficacy of PNT in lowering intraocular pressure (IOP) in patients treated for open angle glaucoma (OAG) and ocular hypertension (OH).
The study group consisted of 24 eyes of 14 patients (10 F and 4 M), aged from 35 to 72 (mean 53.7 +/- 8.7) who were treated for OAG or OH. Twelve patients were treated with prostaglandin analogues (PA) in monotherapy, one patient with PG and nonselective beta-bloker (BB) and one patient with PG, BB and topical carbonic anhydrase inhibitor (CAI). The baseline mean IOP measured with Goldmann tonometry one hour before first PNT procedure was 20.7 +/- 3.3 mmHg (range 16-27). The PNT was performed routinely at 0 and 7-10 day using PNT Unit 1000-Coronado (Ophthalmic International, Inc., Fountain Hills, Arizona, U.S.A.). Then the IOP was measured monthly and if increased to the preoperative values the procedure was repeated. The mean observation time was 6 months, with the shortest and longest follow-up being 4 and 12 months, respectively. The IOP changes were estimated one hour after the first PNT on day 0, then on day 7-10, after 1, 2, 3, 4, 5 and 6 months. A paired Student's t test was used for statistical analysis.
The mean IOP measured one hour after PNT was 19.26 +/- 4.0 mmHg (p = 0.17). After 7 days mean IOP was 17.35 +/- 2.64 mmHg (p<0.01), after one month 16.52 +/- 2.81 mmHg (p<0.01) and after next months 16.37 +/- 2.61 mmHg (p<0.01), 17.63 +/- 2.28 mmHg (p<0.01), 15.64 +/- 2.06 mmHg (p<0.01), 16.14 +/- 3.42 mmHg (p< 0.01) i 16.64 +/- 3.14 mmHg (p<0.01), respectively. The mean IOP reduction was 1.48 mmHg (7.14%) one hour after PNT procedure, 3.39 mmHg (16.35%) after 7-10 days, 4,22 mmHg (20.35%) after one month, then respectively 4.37 mmHg (21.07%), 3.11 mmHg (15.02%), 5.10 mmHg (24.59%), 4.60 mmHg (22.18%) and 4.10 mmHg (19.77%) after 2, 3, 4, 5 and 6 months of observation. In 8 eyes the procedure was repeated again after 3 months, in 4 eyes after 6 months and in 2 eyes after 12 months. After the procedures transient moderate conjunctival hyperemia was observed in 24 eyes (100%) and mild subconjunctival hemorrhagies in 4 eyes (16%). Lasting a few hours after the PNT procedure foreign body sensations occured in 3/14 patients (21%).
PNT is an effective method of lowering IOP in patients treated for OAG and OH.
评估经皮穿刺小梁成形术（PNT）降低开角型青光眼（OAG）和高眼压症（OH）患者眼压（IOP）的疗效。
研究组包括14例患者的24只眼（10例女性和4例男性），年龄在35至72岁之间（平均53.7±8.7岁），均接受OAG或OH治疗。12例患者接受前列腺素类似物（PA）单药治疗，1例患者接受PG和非选择性β受体阻滞剂（BB）治疗，1例患者接受PG、BB和局部碳酸酐酶抑制剂（CAI）治疗。首次PNT手术前1小时用戈德曼眼压计测量的基线平均眼压为20.7±3.3 mmHg（范围16 - 27）。使用PNT Unit 1000 - Coronado（美国亚利桑那州喷泉山眼科国际公司）在0天和7 - 10天常规进行PNT。然后每月测量眼压，若眼压升高至术前值则重复该手术。平均观察时间为6个月，最短和最长随访时间分别为4个月和12个月。在第0天首次PNT后1小时、第7 - 10天、1、2、3、4、5和6个月评估眼压变化。采用配对t检验进行统计分析。
PNT后1小时测量的平均眼压为19.26±4.0 mmHg（p = 0.17）。7天后平均眼压为17.35±2.64 mmHg（p<0.01），1个月后为16.52±2.81 mmHg（p<0.01），随后几个月分别为16.37±2.61 mmHg（p<0.01）、17.63±2.28 mmHg（p<0.01）、15.64±2.06 mmHg（p<0.01）、16.14±3.42 mmHg（p<0.01）和16.64±3.14 mmHg（p<0.01）。PNT手术后1小时平均眼压降低1.48 mmHg（7.14%），7 - 10天后降低3.39 mmHg（16.35%），1个月后降低4.22 mmHg（20.35%），随后在观察2、3、4、5和6个月后分别降低4.37 mmHg（21.07%）、3.11 mmHg（15.02%）、5.10 mmHg（24.59%）、4.60 mmHg（22.18%）和4.10 mmHg（19.77%）。8只眼在3个月后再次进行该手术，4只眼在6个月后进行，2只眼在12个月后进行。手术后，24只眼（100%）出现短暂性中度结膜充血，4只眼（16%）出现轻度结膜下出血。PNT手术后数小时，3/14例患者（21%）出现异物感。
PNT是降低OAG和OH患者眼压的有效方法。
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