De Keyser Myrjam, De Belder Maya, De Groot Veva
Department of Medicine, University of Antwerp, Univer-siteitsplein, Antwerp B-2610, Belgium.
Department of Experimental Psychology, Faculty of Psychology and Education, Ghent University, Henri Dunantlaan, Ghent B-9000, Belgium.
Int J Ophthalmol. 2017 Apr 18;10(4):593-598. doi: 10.18240/ijo.2017.04.15. eCollection 2017.
To compare the efficacy of selective laser trabeculoplasty (SLT) in replacing medical therapy in pseudophakic and phakic eyes.
Subgroup of a prospective randomized clinical trial including patients with primary open angle glaucoma or ocular hypertension controlled with medication. Of 38 pseudophakic eyes were matched with 38 phakic eyes. SLT was offered as a way to decrease medication while maintaining the same low eye pressure. SLT was performed over 360°, at 3ns, spotsize 400 µm, 100 spots. Data [intraocular pressure (IOP), number of medications needed] were measured at 1h, 1wk, 1, 3, 6 and 12mo. An independent-samples -test was performed to compare baseline characteristics of the phakic and the pseudophakic group and differences in evolution of mean IOP and number of used medications. Chi-squared analysis was performed to investigate proportions of fast, slow and non-responders.
The mean IOP measurement was 13.00± 2.88 mm Hg in the phakic group (38 eyes) and 13.51±3.06 mm Hg in the pseudophakic group (38 eyes) (>0.05). This changed little after SLT and IOP lowering effect was comparable between the two groups. Main aim however was to lower the amount of medication needed. In the phakic group medication lowered from 1.29±0.62 at baseline, to 0.15±0.46 after 12mo; a reduction of 88.37%. In the pseudophakic group, used medication changed from 1.71±1.04, to 0.41±0.61; a 76.02% reduction. The differences were not statistically significant at any time point (>0.05). IOP lowering occurred slightly faster in the pseudophakic group (50% of patients after one week) than in the phakic group (68% of patients after more than 4wk). The difference was not significant (>0.05).
IOP lowering effect of SLT is comparable between phakic and pseudophakic eyes.
比较选择性激光小梁成形术（SLT）替代药物治疗在人工晶状体眼和有晶状体眼中的疗效。
一项前瞻性随机临床试验的亚组研究，纳入通过药物控制的原发性开角型青光眼或高眼压症患者。38只人工晶状体眼与38只有晶状体眼进行匹配。SLT作为一种在维持相同低眼压的同时减少药物使用的方法。SLT在360°范围内进行，脉宽3ns，光斑大小400μm，100个光斑。在1小时、1周、1个月、3个月、6个月和12个月时测量数据[眼压（IOP）、所需药物数量]。进行独立样本t检验以比较有晶状体组和人工晶状体组的基线特征以及平均眼压和所用药物数量变化的差异。进行卡方分析以研究快速、缓慢和无反应者的比例。
有晶状体组（38只眼）的平均眼压测量值为13.00±2.88mmHg，人工晶状体组（38只眼）为13.51±3.06mmHg（>0.05）。SLT后变化不大，两组的眼压降低效果相当。然而，主要目的是减少所需药物的数量。有晶状体组的药物从基线时的1.29±0.62降至12个月后的0.15±0.46；减少了88.37%。在人工晶状体组中，所用药物从1.71±1.04变为0.41±0.61；减少了76.02%。在任何时间点差异均无统计学意义（>0.05）。人工晶状体组眼压降低略快于有晶状体组（1周后50%的患者）（4周后68%的患者）。差异不显著（>0.05）。
SLT在有晶状体眼和人工晶状体眼中的眼压降低效果相当。
