Ophthalmology Department, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria.
Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK.
Clin Exp Ophthalmol. 2018 Dec;46(9):1041-1047. doi: 10.1111/ceo.13328. Epub 2018 Jun 17.
To investigate the safety, effectiveness and follow-up rates after transscleral diode laser cyclophotocoagulation as primary treatment for seeing eyes with primary open angle glaucoma in Bauchi, Nigeria.
There is a high prevalence of primary open angle glaucoma in Africa where adherence to medical treatment and acceptance of surgery are poor.
Prospective case series.
New glaucoma patients where surgical intervention was recommended.
A diode 810 nm laser G-probe was used under retrobulbar anaesthesia to deliver approximately 20 shots for 2000 ms, titrating the power. If both eyes were treated the first was the study eye. Repeat treatment offered if the intraocular pressure (IOP) was >21 mmHg on two consecutive visits.
IOP < 22 mmHg, change in ≥2 lines of Snellen visual acuity (VA), and complications.
201 out of 204 eyes with complete data analysed. Mean age 52 years, 17 (8.3%) eyes were re-treated. Mean pre-treatment IOP was 39 (SD 11) mmHg. 106 (53%) attended at 12 months when the mean IOP was 19 (7-45) mmHg; 77 (73%) had IOP < 22 mmHg. VAs were better in 13 (12.3%) and worse in 23 (21.7%) eyes. Postoperative complications included mild uveitis (5.5%), corneal oedema (2.5%), severe uveitis (0.5%) and transient hypotony (2.0%). No hypotony at 12 months.
Transscleral diode laser cyclophotocoagulation controlled IOP in almost three quarters of eyes at 12 months with short-term preservation of vision and minimal complications. Poor follow-up in this setting highlights the need for an effective, safe and acceptable treatment where regular follow-up is less critical.
在尼日利亚包奇州，对原发性开角型青光眼的未治疗眼进行巩膜二极管激光睫状体光凝术作为主要治疗方法，研究其安全性、有效性和随访率。
原发性开角型青光眼在非洲的发病率很高，那里患者对药物治疗的依从性和对手术的接受程度都很差。
前瞻性病例系列。
推荐手术干预的新青光眼患者。
在球后麻醉下使用二极管 810nm 激光 G 探头，大约发射 20 次，每次 2000ms，调节功率。如果双眼都接受治疗，则第一只眼为研究眼。如果两次连续就诊时眼压（IOP）>21mmHg，则提供重复治疗。
IOP<22mmHg、≥2 行 Snellen 视力（VA）变化和并发症。
对 204 只具有完整数据的眼睛进行了分析。平均年龄为 52 岁，17 只（8.3%）眼睛需要再次治疗。平均治疗前 IOP 为 39（SD 11）mmHg。106 只（53%）在 12 个月时接受了随访，此时平均 IOP 为 19（7-45）mmHg；77 只（73%）IOP<22mmHg。13 只（12.3%）眼睛的视力更好，23 只（21.7%）眼睛的视力更差。术后并发症包括轻度葡萄膜炎（5.5%）、角膜水肿（2.5%）、严重葡萄膜炎（0.5%）和短暂性低眼压（2.0%）。12 个月时无低眼压。
在 12 个月时，巩膜二极管激光睫状体光凝术控制了近四分之三的眼睛的 IOP，同时短期保留了视力，并发症最小。在这种情况下，随访不佳突出表明需要一种有效、安全且可接受的治疗方法，因为在这种治疗方法中，定期随访的重要性较低。
