Duan Xiaoming, He Zhongjiang, Zhang Xuxiang
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab., Beijing, China.
Photomed Laser Surg. 2010 Feb;28(1):109-13. doi: 10.1089/pho.2008.2457.
The aim of this investigation was to evaluate the efficacy of reduction in intraocular pressure (IOP) and complications in ab externo superpulse carbon dioxide laser-assisted trabeculectomy.
Reduction of IOP remains the immediate goal of glaucoma treatment. Although trabeculectomy has been considered the gold standard for the surgical treatment of glaucoma, many complications are associated with this procedure. Laser surgery has been studied as an alternative way to control IOP in glaucoma.
Sixty adult albino rabbits were enrolled in this study. The animals underwent one unilateral surgery of either trabeculectomy or ab externo superpulse carbon dioxide laser-assisted trabeculectomy and were divided into two subgroups, control or experimental. Follow-up examinations included ocular anterior segments, filtration blebs and IOP. Five eyes in each group were analyzed histologically one month postoperatively.
Anterior chamber hyphema in the laser group was milder than that in the surgery group, and disappeared on the third day. In the surgery group, it disappeared by the end of the first month. Filtration blebs in the laser group formed earlier than in the surgery group. Comparing the laser group and the surgery group, IOP values in the laser group were more stable. Histological examination showed that the sclera tract was blocked by scar tissue, inflammation had infiltrated, and the anterior chamber angle had adhered in the surgery group.
Ab externo superpulse carbon dioxide laser-assisted trabeculectomy was suggested as a feasible technique to control IOP with the advantages of more steady IOP reduction and fewer complications.
本研究旨在评估外路超脉冲二氧化碳激光辅助小梁切除术降低眼压(IOP)的疗效及并发症情况。
降低眼压仍然是青光眼治疗的直接目标。尽管小梁切除术一直被视为青光眼手术治疗的金标准,但该手术存在许多并发症。激光手术已被作为控制青光眼眼压的一种替代方法进行研究。
本研究纳入60只成年白化兔。这些动物接受了小梁切除术或外路超脉冲二氧化碳激光辅助小梁切除术的单侧手术,并分为两个亚组,即对照组和实验组。随访检查包括眼前节、滤过泡和眼压。术后1个月对每组5只眼进行组织学分析。
激光组前房积血比手术组轻,在第3天消失。手术组前房积血在第一个月末消失。激光组滤过泡形成早于手术组。比较激光组和手术组,激光组眼压值更稳定。组织学检查显示手术组巩膜通道被瘢痕组织阻塞,有炎症浸润,前房角粘连。
外路超脉冲二氧化碳激光辅助小梁切除术被认为是一种控制眼压的可行技术,具有眼压降低更稳定、并发症更少的优点。