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单眼选择性激光小梁成形术治疗开角型青光眼后的角膜变化。

Corneal changes after a single session of selective laser trabeculoplasty for open-angle glaucoma.

机构信息

Department of Ophthalmology, University of Hong Kong, Hong Kong, People's Republic of China.

Department of Ophthalmology, Queen Mary Hospital, Hong Kong, People's Republic of China.

出版信息

Eye (Lond). 2014 Jan;28(1):47-52. doi: 10.1038/eye.2013.231. Epub 2013 Oct 18.

Abstract

PURPOSE

To investigate the changes in endothelial cell count, central corneal thickness (CCT), and refractive error after a session of selective laser trabeculoplasty (SLT) for open angle glaucoma (OAG).

METHODS

This prospective cohort study recruited 111 eyes of 66 consecutive subjects with OAG. Subjects received SLT to 360° of the trabecular meshwork. Endothelial cell count, CCT, and spherical equivalent were measured at baseline before SLT as well as at 1 week and 1 month post SLT. A repeated measure nested ANOVA with Tukey's multiple comparison test was performed to compare the outcome measures before and after SLT.

RESULTS

In 111 eyes of 66 subjects, the mean number of laser applications per treatment was 166.9 ± 41.4 with a mean energy level of 1.0 ± 0.07 mJ. The mean endothelial cell count decreased significantly from 2465.0 ± 334.0 cells/mm(2) at baseline to 2355.0 ± 387.0 cells/mm(2) at 1 week (P=0.0004) but increased to baseline levels at 1 month post SLT (2424.0 ± 379.4 cells/mm(2), P=0.3). The CCT, which decreased from a baseline of 549.4 ± 37.6 to 543.9 ± 40.2 μm at 1 week post SLT (P=0.02), also returned to the baseline level by 1 month (P=0.2). The spherical equivalent was static from baseline. A positive correlation was found between total laser energy and CCT at 1 month post treatment (r=0.3, P=0.005).

CONCLUSION

The transient reductions in endothelial cell count and CCT following SLT returned to baseline levels 1 month after the procedure. Patients undergoing SLT should be aware of the risk of potential corneal changes.

摘要

目的

研究选择性激光小梁成形术(SLT)治疗开角型青光眼(OAG)后内皮细胞计数、中央角膜厚度(CCT)和屈光不正的变化。

方法

本前瞻性队列研究纳入了 66 例连续 OAG 患者的 111 只眼。患者接受了 360°小梁网 SLT。在 SLT 前、后 1 周和 1 个月分别测量内皮细胞计数、CCT 和球镜等效值。采用重复测量嵌套方差分析和 Tukey 多重比较检验比较 SLT 前后的各项指标。

结果

在 66 例患者的 111 只眼中,每次治疗的平均激光应用次数为 166.9±41.4 次,平均能量水平为 1.0±0.07 mJ。平均内皮细胞计数从基线时的 2465.0±334.0 个/平方毫米显著下降至治疗后 1 周的 2355.0±387.0 个/平方毫米(P=0.0004),但在 SLT 后 1 个月恢复至基线水平(2424.0±379.4 个/平方毫米,P=0.3)。CCT 从基线时的 549.4±37.6μm 下降至治疗后 1 周的 543.9±40.2μm(P=0.02),1 个月后也恢复至基线水平(P=0.2)。球镜等效值从基线时保持稳定。治疗后 1 个月,总激光能量与 CCT 呈正相关(r=0.3,P=0.005)。

结论

SLT 后内皮细胞计数和 CCT 的短暂减少在治疗后 1 个月恢复至基线水平。接受 SLT 的患者应意识到潜在角膜变化的风险。

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