Jules Gonin Eye Hospital, University of Lausanne, Lausanne, Switzerland.
Eye (Lond). 2011 Dec;25(12):1655-7. doi: 10.1038/eye.2011.231. Epub 2011 Sep 16.
The purpose of this study was to evaluate the intraocular pressure (IOP)-lowering effect of modified goniopuncture with the 532-nm Nd : YAG selective laser trabeculoplasty (SLT) laser on eyes after deep sclerectomy with collagen implant (DSCI). This was an interventional cased series. The effects of modified goniopuncture on eyes with insufficient IOP-lowering after DSCI were observed. Goniopuncture was performed using a Q-switched, frequency-doubled 532-nm Nd : YAG laser (SLT-goniopuncture, SLT-G). Outcome measures were amount of IOP-lowering and rapidity of decrease after laser intervention. In all, 10 eyes of 10 patients with a mean age of 71.0±7.7 (SD) years were treated with SLT-G. The mean time of SLT-G after DSCI procedure was 7.1±10.9 months. SLT-G decreased IOP from an average of 16.1±3.4 mm Hg to 14.2±2.8 mm Hg (after 15 min), 13.6±3.9 mm Hg (at 1 day), 12.5±4.1 mm Hg (at 1 month), and 12.6±2.5 (at 6 months) (P<0.0125). There were no complications related to the intervention. Patients in this series achieved an average 22.5% of IOP reduction after SLT-G. The use of the SLT laser appears to be an effective and safe alternative to the traditional Nd : YAG laser for goniopuncture in eyes after DSCI, with potential advantages related to non-perforation of trabeculo-descemet's membrane (TDM).
本研究旨在评估经巩膜胶原植入深层巩膜切除术（DSCI）后行改良式房角穿刺术联合 532nmNd:YAG 选择性激光小梁成形术（SLT）对眼压（IOP）的降低效果。这是一项干预性病例系列研究。观察改良式房角穿刺术对 DSCI 后 IOP 降低不足的眼的效果。使用 Q 开关、倍频 532nmNd:YAG 激光（SLT-房角穿刺术，SLT-G）进行房角穿刺。主要观察指标为激光干预后的眼压降低量和降低速度。共纳入 10 例（10 只眼）年龄 71.0±7.7（SD）岁的患者接受 SLT-G 治疗。SLT-G 距 DSCI 后时间的平均为 7.1±10.9 个月。SLT-G 使眼压从平均 16.1±3.4mmHg 降至 14.2±2.8mmHg（术后 15 分钟）、13.6±3.9mmHg（术后 1 天）、12.5±4.1mmHg（术后 1 个月）和 12.6±2.5mmHg（术后 6 个月）（P<0.0125）。无与干预相关的并发症。本系列患者 SLT-G 后平均 IOP 降低 22.5%。SLT 激光的应用似乎是 DSCI 后行传统 Nd:YAG 激光房角穿刺术的有效且安全的替代方法，具有与小梁-内皮膜（TDM）非穿孔相关的潜在优势。
