University of Texas Southwestern Medical Center at Dallas, TX 75390-9057, USA.
Curr Med Res Opin. 2009 Mar;25(3):787-96. doi: 10.1185/03007990902728316.
To investigate the effect of selective laser trabeculoplasty (SLT) on the intraocular pressure (IOP) of untreated fellow eyes in patients with open-angle glaucoma.
Retrospective chart review.
Charts of all patients who underwent SLT at the University of Texas Southwestern Medical Center at Dallas between September 2003 and May 2006 were reviewed. Each patient had IOP measurements by Goldmann applanation tonometry in both eyes preoperatively, and at 1 hour, 2 weeks, 3 months, and 6 months postoperatively. Patient age, gender, diagnosis, central corneal thickness (CCT), previous intraocular surgeries, and degrees of laser treatment were tabulated for each patient. Patients with a history of previous glaucoma surgery in either eye were excluded as were those who underwent any change in glaucoma medications or further laser or surgical intervention in either eye within 6 months of SLT. Data were analyzed using a paired two-tailed t-test, an unpaired two-tailed t-test, ANOVA, and linear regression.
A total of 43 patients were included through 6 months of follow-up. Mean reduction in IOP in the treated eye was 3.9 +/- 0.6 mmHg or 18.8% (p < 0.001) at final exam. Mean IOP reduction in the fellow untreated eye was 2.1 +/- 0.5 mmHg or 11.2% (p < 0.01). Patients with higher preoperative IOPs had a greater reduction in IOP in both eyes (p < 0.001 for treated eyes, and p = 0.02 for untreated eyes). Patients who were on a larger number of glaucoma medications preoperatively had a greater response in both eyes (treated eye p = 0.002, untreated eye p = 0.008). There was no significant difference in IOP response in either eye based on age, gender, CCT, degrees of treatment, or phakic status.
SLT produces a sustained and statistically significant IOP reduction in the fellow untreated eyes of patients with open-angle glaucoma. The results of our study support a biological mechanism of action for SLT. Limitations of this study include its retrospective design, relatively small sample size, a possible effect of increased compliance with medical therapy following SLT, and an inherent bias of excluding patients who underwent a change in medications or further laser or surgical therapy during the period under review.
研究选择性激光小梁成形术（SLT）对开角型青光眼患者未治疗对侧眼眼压（IOP）的影响。
回顾性图表审查。
回顾了 2003 年 9 月至 2006 年 5 月期间在达拉斯德克萨斯大学西南医学中心接受 SLT 的所有患者的图表。每位患者在术前和术后 1 小时、2 周、3 个月和 6 个月均通过 Goldmann 压平眼压计测量双眼 IOP。为每位患者列出了患者年龄、性别、诊断、中央角膜厚度（CCT）、既往眼内手术以及激光治疗程度。排除了双眼均有既往青光眼手术史的患者，以及在 SLT 后 6 个月内双眼接受任何降眼压药物改变或进一步激光或手术干预的患者。使用配对双侧 t 检验、非配对双侧 t 检验、方差分析和线性回归分析数据。
共有 43 例患者在 6 个月的随访中完成。治疗眼的平均眼压下降 3.9 +/- 0.6 mmHg 或 18.8%（p < 0.001）。未治疗眼的平均眼压下降 2.1 +/- 0.5 mmHg 或 11.2%（p < 0.01）。术前IOP较高的患者双眼眼压下降幅度更大（治疗眼 p < 0.001，未治疗眼 p = 0.02）。术前使用较多降眼压药物的患者双眼反应更大（治疗眼 p = 0.002，未治疗眼 p = 0.008）。未治疗眼的眼压反应与年龄、性别、CCT、治疗程度或晶体状态无关。
SLT 可使开角型青光眼患者的未治疗对侧眼眼压持续且具有统计学意义的降低。我们的研究结果支持 SLT 的生物学作用机制。本研究的局限性包括其回顾性设计、样本量相对较小、SLT 后药物治疗依从性增加的可能影响，以及排除在审查期间接受药物或进一步激光或手术治疗改变的患者所产生的固有偏倚。
