Tardif A, Bonnin N, Borel A, Viennet A, Pereira B, Chiambaretta F
Service d'ophtalmologie, pôle RMND-M2O, CHU de Clermont-Ferrand, 58, rue Montalembert, 63003 Clermont-Ferrand, France.
Service d'ophtalmologie, pôle RMND-M2O, CHU de Clermont-Ferrand, 58, rue Montalembert, 63003 Clermont-Ferrand, France.
J Fr Ophtalmol. 2014 May;37(5):353-7. doi: 10.1016/j.jfo.2013.08.008. Epub 2014 Mar 26.
To compare the results obtained with SLT trabeculoplasty after an initial treatment (SLT-1) and after a second treatment (SLT-2). Subgroup analysis according to trabecular pigmentation and the existence of a high myopia.
Retrospective study of 77 patients, 152 SLT sessions performed in the Ophthalmology Department of Clermont-Ferrand University Medical Center, 118 SLT-1, 34 SLT-2. Three comparable groups of patients were assembled: group 1 (glaucoma patients with normal or subnormal trabecular pigmentation), group 2 (glaucoma patients with high myopia), and group 3 (glaucoma patients with significant trabecular pigmentation). The results were compared between groups, for SLT-1 and SLT-2.
Intraocular pressure lowering was consistent with data reported in the literature. Comparison of the results of SLT-1 versus SLT-2 did not find any significant difference in terms of IOP change. However, after SLT-2, the IOP response appears significantly greater (P=0.03) in the group with significant trabecular pigmentation compared to the non-myopic group with normal trabecular pigmentation.
Our results are consistent with the literature for efficacy, tolerance and reproducibility of SLT. No reduction in SLT efficacy was observed after a second session. Trabecular pigmentation is not a predictor of the response after the first session. In the case of retreatment (SLT-2), the differences observed lead to the hypothesis that it may be appropriate to perform at least two SLT treatments in patients with significant trabecular pigmentation in order to obtain maximal effect. Myopia, a variable not previously studied, does not seem to influence SLT outcomes.
Trabecular pigmentation and the presence of myopia do not appear to be predictive of a successful first treatment. However, our study leads us to suggest the hypothesis that the maximal response of SLT in patients with significant trabecular pigmentation is not obtained until after at least two sessions. This observation opens an interesting perspective on the therapeutic strategy to adopt in the case of pigmentary glaucoma.
比较初次治疗（SLT - 1）和二次治疗（SLT - 2）后选择性激光小梁成形术（SLT）的效果。根据小梁色素沉着和高度近视情况进行亚组分析。
对克莱蒙费朗大学医学中心眼科进行的152次SLT治疗的77例患者进行回顾性研究，其中118次为SLT - 1，34次为SLT - 2。将患者分为三个可比组：第1组（小梁色素沉着正常或低于正常的青光眼患者），第2组（高度近视的青光眼患者），第3组（小梁色素沉着明显的青光眼患者）。比较SLT - 1和SLT - 2组间的结果。
眼压降低情况与文献报道的数据一致。SLT - 1与SLT - 2结果比较，眼压变化方面未发现显著差异。然而，SLT - 2后，小梁色素沉着明显的组与小梁色素沉着正常的非近视组相比，眼压反应明显更大（P = 0.03）。
我们的结果在SLT的疗效、耐受性和可重复性方面与文献一致。第二次治疗后未观察到SLT疗效降低。小梁色素沉着不是第一次治疗后反应的预测指标。在再次治疗（SLT - 2）的情况下，观察到的差异导致这样一种假设，即对于小梁色素沉着明显的患者，为获得最大效果可能至少进行两次SLT治疗是合适的。近视，一个此前未研究过的变量，似乎不影响SLT结果。
小梁色素沉着和近视似乎不是首次治疗成功的预测指标。然而，我们的研究使我们提出这样一种假设，即小梁色素沉着明显的患者至少在两次治疗后才能获得SLT的最大反应。这一观察结果为色素性青光眼的治疗策略开辟了一个有趣的视角。
