Kuchar Sarah, Moster Marlene R, Reamer Courtney B, Waisbourd Michael
Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA, 19107, USA.
Lasers Med Sci. 2016 Feb;31(2):393-6. doi: 10.1007/s10103-015-1856-9. Epub 2015 Dec 29.
Glaucoma is the leading cause of irreversible blindness worldwide. The goal of this study was to describe our experience with the novel micropulse transscleral cyclophotocoagulation (MP-TSCPC; IRIDEX IQ810 Laser Systems, CA) in patients with advanced glaucoma. Patients with advanced glaucoma who underwent MP-TSCPC were included in our study. Laser settings were 2000 mW of 810 nm infrared diode laser set on micropulse delivery mode. The laser was delivered over 360° for 100-240 s. The duty cycle was 31.3 %, which translated to 0.5 ms of "on time" and 1.1 ms of "off time." Surgical success was defined as an intraocular pressure (IOP) of 6-21 mmHg or a reduction of IOP by 20 % at the last follow-up visit. Failure was defined as an inability to meet the criteria for success or a need for incisional glaucoma surgery. Nineteen patients underwent MP-TSCPC with mean follow-up of 60.3 days. Mean IOP dropped from 37.9 mmHg preoperatively to 22.7 mmHg at last follow-up, representing a 40.1 % decrease. The success rate for initial treatment was 73.7 % (n = 14). Three patients underwent a second treatment, increasing the overall success rate to 89.5 % (n = 17). Four patients gained one line of vision, and four patients lost one line of vision. The novel MP-TSCPC laser had a high rate of surgical success after a short follow-up period in patients with advanced glaucoma. Further long-term evaluation and comparison to the traditional transscleral cyclophotocoagulation are warranted.
青光眼是全球不可逆性失明的主要原因。本研究的目的是描述我们在晚期青光眼患者中使用新型微脉冲经巩膜睫状体光凝术（MP-TSCPC；IRIDEX IQ810激光系统，加利福尼亚州）的经验。接受MP-TSCPC的晚期青光眼患者被纳入我们的研究。激光设置为810纳米红外二极管激光，功率2000毫瓦，采用微脉冲发射模式。激光在360°范围内发射100 - 240秒。占空比为31.3%，即“开启时间”为0.5毫秒，“关闭时间”为1.1毫秒。手术成功定义为在最后一次随访时眼压（IOP）为6 - 21毫米汞柱或眼压降低20%。失败定义为未达到成功标准或需要进行切开性青光眼手术。19例患者接受了MP-TSCPC，平均随访60.3天。平均眼压从术前的37.9毫米汞柱降至最后一次随访时的22.7毫米汞柱，降低了40.1%。初始治疗的成功率为73.7%（n = 14）。3例患者接受了二次治疗，使总体成功率提高到89.5%（n = 17）。4例患者视力提高了一行，4例患者视力下降了一行。新型MP-TSCPC激光在晚期青光眼患者短期随访后手术成功率较高。有必要进行进一步的长期评估并与传统经巩膜睫状体光凝术进行比较。
