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选择性激光小梁成形术后的不良反应和短期效果。

Adverse effects and short-term results after selective laser trabeculoplasty.

机构信息

Department of Ophthalmology, University Medicine Charité Berlin, Berlin, Germany.

出版信息

J Glaucoma. 2014 Feb;23(2):105-8. doi: 10.1097/IJG.0b013e3182684fd1.

Abstract

PURPOSE

To evaluate the risk of adverse effects and to demonstrate short-term results after selective laser trabeculoplasty (SLT) in glaucoma patients.

METHODS

Sixty-four eyes of 64 patients with primary open-angle glaucoma, not sufficiently treated with local antiglaucomatous therapy, were included in this prospective study. Intraocular pressure (IOP), anterior chamber cells, anterior chamber flare, and vitreous haze (according to the Standardization of Uveitis Nomenclature Working Group) were examined before SLT, for 24 hours, 14 days, 6 weeks, and 3 months after laser. Furthermore, macular thickness measurements in 9 Early Treatment Diabetic Retinopathy Study subfields, including central subfield, measured by Spectralis OCT were performed. The differences between prelaser and postlaser values were obtained.

RESULTS

The average of mean preoperative IOP measurement was 19.1±3.972 mm Hg compared with 12.9±2.513 (P<0.001), 13.2±3.331 (P<0.001), 14.1±2.731 (P<0.001), and 13.9±2.922 mm Hg (P<0.001) 24 hours, 14 days, 6 weeks, and 3 months post-SLT, respectively. The central subfield preoperatively was 278.14±74.355 µm compared with 277.14±71.461 (P=0.177), 277.14±71.461 (P=0.354), 287.34±74.363 (P=0.414), and 257.45±68.431 µm (P=0.214) 24 hours, 14 days, 6 weeks, and 3 months after treatment. Anterior chamber cells, anterior chamber flare, and vitreous haze were not denoted at any time of examination.

CONCLUSIONS

In this study, no significant increase in macular thickness and no other adverse effects were present. Furthermore, SLT was found to significantly lower IOP in glaucoma patients in addition to local therapy. In conclusion, SLT has a good ability to reduce IOP with a minor risk of adverse effects.

摘要

目的

评估选择性激光小梁成形术(SLT)治疗青光眼患者的不良反应风险,并展示短期疗效。

方法

本前瞻性研究纳入了 64 例原发性开角型青光眼患者的 64 只眼,这些患者局部抗青光眼治疗效果不佳。在 SLT 前、术后 24 小时、14 天、6 周和 3 个月,我们检查了眼压(IOP)、前房细胞、前房闪辉和玻璃体内混浊(根据眼后段葡萄膜炎研究组标准化命名标准),并使用 Spectralis OCT 对包括中央凹在内的 9 个早期糖尿病性视网膜病变研究亚区的黄斑厚度进行了测量。获得了激光治疗前后的差值。

结果

平均术前 IOP 测量值为 19.1±3.972mmHg,与术后 24 小时(12.9±2.513mmHg,P<0.001)、14 天(13.2±3.331mmHg,P<0.001)、6 周(14.1±2.731mmHg,P<0.001)和 3 个月(13.9±2.922mmHg,P<0.001)时相比,差异均有统计学意义。术前中央凹区厚度为 278.14±74.355µm,与术后 24 小时(277.14±71.461µm,P=0.177)、14 天(277.14±71.461µm,P=0.354)、6 周(287.34±74.363µm,P=0.414)和 3 个月(257.45±68.431µm,P=0.214)时相比,差异无统计学意义。任何检查时间均未观察到前房细胞、前房闪辉和玻璃体内混浊。

结论

在这项研究中,治疗后未见黄斑厚度显著增加和其他不良反应。此外,除局部治疗外,SLT 还能显著降低青光眼患者的眼压。总之,SLT 降低眼压的能力较好,不良反应风险较小。

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