Sanchez F G, Lerner F, Sampaolesi J, Noecker R, Becerra N, Iribarren G, Grippo T M
Grippo Glaucoma Center, Buenos Aires, Argentina.
Centro Oftalmológico Lerner, Buenos Aires, Argentina.
Arch Soc Esp Oftalmol (Engl Ed). 2018 Dec;93(12):573-579. doi: 10.1016/j.oftal.2018.08.003. Epub 2018 Oct 2.
To report the results using Micropulse transscleral cyclophotocoagulation (Iridex) in the treatment of glaucoma.
Retrospective study in adult patients with glaucoma with at least 6 months of follow-up, and only one session of Micropulse. The same surgical technique was used in all cases. The only laser parameter that could vary was the total treatment duration (in seconds). The remaining parameters were fixed at 2 Watts of power and 0.5ms (31.3%) of active cycle.
A total of 22 eyes of 17 patients with glaucoma of various types and stages were included (mainly congenital and pseudoexfoliation). The mean follow-up time was 7.9 months. The total treatment duration varied from 100 to 180seconds. Definition of success: 5mmHg <Intraocular pressure (IOP)<21mmHg and a reduction of ≥20% of the baseline value and no addition of oral carbonic anhydrase inhibitors, and no re-operation. The overall success rate was 72.7% in the first month, 54% at 4 months, 41% at 6 months, and 27.3% at final follow-up. Patients with longer treatment durations (180s) achieved better results. The mean reduction in IOP in successful eyes was 36% (from 26.3 to 16.7mmHg, SD 4.58, P=.028). No complications were reported.
In a heterogeneous population of glaucoma (mostly congenital and pseudoexfoliation types), a low success rate (27.3%) was obtained in the medium-term with a single session of Micropulse.
报告使用微脉冲经巩膜睫状体光凝术(Iridex)治疗青光眼的结果。
对成年青光眼患者进行回顾性研究,随访至少6个月,且仅进行一次微脉冲治疗。所有病例均采用相同的手术技术。唯一可变化的激光参数是总治疗持续时间(以秒为单位)。其余参数固定为2瓦功率和0.5毫秒(31.3%)的激活周期。
共纳入17例不同类型和阶段青光眼患者的22只眼(主要为先天性和剥脱性)。平均随访时间为7.9个月。总治疗持续时间从100秒至180秒不等。成功定义为:眼压(IOP)<21mmHg且比基线值降低≥20%,未加用口服碳酸酐酶抑制剂,且未再次手术。第一个月总体成功率为72.7%,4个月时为54%,6个月时为41%,末次随访时为27.3%。治疗持续时间较长(180秒)的患者取得了更好的效果。成功眼的眼压平均降低36%(从26.3mmHg降至16.7mmHg,标准差4.58,P = 0.028)。未报告并发症。
在异质性青光眼人群(主要为先天性和剥脱性类型)中,单次微脉冲治疗在中期获得的成功率较低(27.3%)。