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激光周边虹膜切开术预防色素性青光眼综合征患者病情进展的长期疗效

[Long-term efficacy of laser peripheral iridotomy in preventing progression in eyes with pigment dispersion syndrome].

作者信息

Qing Guoping, Zhang Shaodan, Wang Huaizhou, Wang Tao, Wang Shuhua, Chen Hong, Wang Hua, Wang Ningli

机构信息

Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab, Beijing 100730, China.

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出版信息

Zhonghua Yan Ke Za Zhi. 2014 Jul;50(7):536-40.

Abstract

OBJECTIVE

To evaluate the long-term efficacy of laser peripheral iridotomy (LPI) in preventing deterioration in eyes with pigment dispersion syndrome (PDS).

METHODS

A cohort study. Nineteen patients with PDS were treated with LPI and followed up periodically in Beijing Tongren Eye Center from May 2006 to April 2007. One eye of each patient was chosen randomly for the study. Main investigating items included iris configuration, intraocular pressure (IOP), anterior chamber pigmentation, and visual field analysis. The average follow-up period was (6.5 ± 0.3) years. A paired sample t test was used to determine whether there is a significant difference between average values of pre- and post-LPI IOP and mean deviation of Humphrey visual field analysis in these PDS eyes.

RESULTS

The average age of the 19 patients were (35.8 ± 7.1) years on admission. The initial IOP of the 19 eyes was (24.7 ± 2.2) mmHg (1 mmHg = 0.133 kPa) before LPI. The mean deviation (MD) of Humphrey visual field analysis (VFA) were (-1.82 ± 1.26) dB (-4.34--0.28 dB) . All 19 eyes had concave iris and heavy trabecular pigmentation. The iris became flat in all PDS eyes after the laser treatment. At the last follow-up visit, the average IOP was 14.8 ± 2.0 (12-20) mmHg, which was statistically lower than that of baseline (t = 11.49, P < 0.01) . Extent of trabecular pigmentation reduced obviously in 16 eyes. No deterioration or new visual field defect was detected in any of the PDS eyes. MD of the last VFA was -1.79 ± 1.21 (-4.39--0.21 dB) . There was no statistical difference between MD of the last VFA and baseline (t = -0.26, P = 0.798).

CONCLUSION

The long-term follow-up results showed that LPI prevents progression effectively in eyes with PDS.

摘要

目的

评估激光周边虹膜切开术(LPI)预防色素播散综合征(PDS)患眼病情恶化的长期疗效。

方法

一项队列研究。2006年5月至2007年4月期间,19例PDS患者在北京同仁眼科中心接受LPI治疗并定期随访。每位患者随机选择一只眼纳入研究。主要观察项目包括虹膜形态、眼压(IOP)、前房色素沉着及视野分析。平均随访时间为(6.5±0.3)年。采用配对样本t检验确定这些PDS患眼LPI术前、后IOP平均值及Humphrey视野分析平均偏差之间是否存在显著差异。

结果

19例患者入院时平均年龄为(35.8±7.1)岁。19只眼LPI术前初始眼压为(24.7±2.2)mmHg(1 mmHg = 0.133 kPa)。Humphrey视野分析(VFA)平均偏差(MD)为(-1.82±1.26)dB(-4.34--0.28 dB)。所有19只眼虹膜均呈凹陷状且小梁色素沉着明显。激光治疗后所有PDS患眼虹膜均变平坦。末次随访时,平均眼压为14.8±2.0(12 - 20)mmHg,较基线水平有统计学意义的降低(t = 11.49,P < 0.01)。16只眼小梁色素沉着程度明显减轻。所有PDS患眼均未发现病情恶化或出现新的视野缺损。末次VFA的MD为-1.79±1.21(-4.39--0.21 dB)。末次VFA的MD与基线水平相比无统计学差异(t = -0.26,P = 0.798)。

结论

长期随访结果表明,LPI可有效预防PDS患眼病情进展。

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