Schuman J S, Puliafito C A, Allingham R R, Belcher C D, Bellows A R, Latina M A, Shingleton B J
Morse Laser Center, Massachusetts Eye and Ear Infirmary, Boston.
Ophthalmology. 1990 May;97(5):571-80. doi: 10.1016/s0161-6420(90)32550-2.
Advanced glaucoma in 140 eyes of 136 patients was treated with contact transscleral continuous wave neodymium:YAG (Nd:YAG) laser cyclophotocoagulation (CYC) with a sapphire-tipped probe. The anterior edge of the probe was placed 0.5 to 1.5 mm posterior to the limbus, using 7 to 9 W of power for 0.7 seconds with 32 to 40 applications, sparing the 3 and 9 o'clock meridians. Patients were studied prospectively. The mean preoperative intraocular pressure (IOP) of 36.7 +/- 0.97 mmHg decreased to 21.2 +/- 0.99 mmHg (P = 0.004) after treatment (mean follow-up, 3.2 +/- 0.35 months) for a mean decrease in IOP of 15.5 +/- 1.21 mmHg and a mean percent decrease of 39%. Forty-one eyes were followed 6 or more months (mean, 6.7 +/- 0.25 months). The CYC reduced IOP to 25 mmHg or less in 71% of eyes, to 22 mmHg or less in 62% of eyes, and to 19 mmHg or less in 49% of eyes. Maximum lowering of IOP occurred 1 week to 1 month after treatment and remained at that level through 6 months of follow-up. Retreatment was required in 11% of patients; only one patient was retreated more than once. Four patients treated with 9 W of power developed IOPs below 5 mmHg; two of these patients had an IOP of 0 mmHg. Other complications of therapy were minimal, and patients had little pain. There was no significant change in visual acuity. Early results of this newly available therapy are encouraging.
对136例患者的140只晚期青光眼眼睛，使用蓝宝石探头的接触式经巩膜连续波钕:钇铝石榴石（Nd:YAG）激光睫状体光凝术（CYC）进行治疗。将探头前缘置于角膜缘后0.5至1.5毫米处，使用7至9瓦功率，每次照射0.7秒，共照射32至40次，避开3点和9点子午线。对患者进行前瞻性研究。治疗后（平均随访3.2±0.35个月），术前平均眼压36.7±0.97毫米汞柱降至21.2±0.99毫米汞柱（P = 0.004），平均眼压降低15.5±1.21毫米汞柱，平均降低百分比为39%。41只眼睛随访6个月或更长时间（平均6.7±0.25个月）。CYC使71%的眼睛眼压降至25毫米汞柱或更低，62%的眼睛眼压降至22毫米汞柱或更低，49%的眼睛眼压降至19毫米汞柱或更低。眼压最大降幅出现在治疗后1周内至1个月，并在随访6个月期间维持在该水平。11%的患者需要再次治疗；只有1例患者接受了不止一次的再次治疗。4例接受9瓦功率治疗的患者眼压低于5毫米汞柱；其中2例患者眼压为0毫米汞柱。治疗的其他并发症极少，患者几乎没有疼痛。视力无明显变化。这种新疗法的早期结果令人鼓舞。
