Sapienza John S, Kim Kay, Rodriguez Elena, DiGirolamo Nicola
Long Island Veterinary Specialists, Plainview, New York.
Tai Wai Small Animal Clinic & Exotic Hospital, Hong Kong, China.
Vet Ophthalmol. 2019 Jul;22(4):520-528. doi: 10.1111/vop.12622. Epub 2018 Oct 25.
The purpose of this study was to report the preliminary results of a novel micropulse transscleral diode laser cyclophotocoagulation (MP-TSCP) as primary therapy for glaucomatous dogs.
Client owned dogs undergoing MP-TSCP therapy at a veterinary referral center.
Retrospective study of dogs with glaucoma that were treated with MP-TSCP with a minimum of 1 month (range: 1-18 months) of follow-up. Reported outcomes were intraocular pressure (IOP), treatment parameters, reduction in medications, complications, and incidence of repeat therapy.
Thirty dogs (35 eyes) were evaluated. The mean age was 9.0 years. Mean preoperative IOP was 34.5 mm Hg. Mean postoperative IOP at 1 month (35/35 eyes) was 22 mm Hg, 2 months (26/35 eyes) was 20.5 mm Hg, 4 months (20/35 eyes) was 19 mm Hg, 6 months (10/35 eyes) was 19 mm Hg, 12 months (8/35 eyes) was 21 mm Hg. First treatment success rate was 19/35 eyes (54.3%). Repeat laser was performed in 11 eyes with 4/11 eyes responding favorably for a total IOP control of 23/35 eyes (65.7%). Mean energy levels employed were 137.5 seconds and 2351 mW at 31.3% duty cycle. Reduction in medications was from a mean of 3.6 medications preoperatively to 3.1 medications postoperatively. Complications included corneal ulcers 5/35 eyes (14.3%), uncontrolled IOP in 12/35 eyes (34.3%) and repeat treatment in 11/35 eyes (31.4%).
MP-TSCP was successful in controlling IOP in most patients as well as to reduce postoperative medications with minimal resultant intraocular inflammation and complications. The micropulse procedure also can be repeated. Future investigations to study effective treatment parameters are warranted in a larger series of patients over a longer period of evaluation.
本研究旨在报告一种新型微脉冲经巩膜二极管激光睫状体光凝术（MP - TSCP）作为青光眼犬原发性治疗方法的初步结果。
在一家兽医转诊中心接受MP - TSCP治疗的客户拥有的犬只。
对接受MP - TSCP治疗且随访时间至少1个月（范围：1 - 18个月）的青光眼犬进行回顾性研究。报告的结果包括眼压（IOP）、治疗参数、药物用量减少情况、并发症以及重复治疗的发生率。
评估了30只犬（35只眼）。平均年龄为9.0岁。术前平均眼压为34.5毫米汞柱。术后1个月（35/35只眼）平均眼压为22毫米汞柱，2个月（26/35只眼）为20.5毫米汞柱，4个月（20/35只眼）为19毫米汞柱，6个月（10/35只眼）为19毫米汞柱，12个月（8/35只眼）为21毫米汞柱。首次治疗成功率为19/35只眼（54.3%）。对11只眼进行了重复激光治疗，其中4/11只眼反应良好，眼压总体控制率为23/35只眼（65.7%）。平均使用的能量水平为137.5秒，占空比31.3%时功率为2351毫瓦。药物用量从术前平均3.6种减少到术后3.1种。并发症包括角膜溃疡5/35只眼（14.3%）、眼压控制不佳12/35只眼（34.3%）以及重复治疗11/35只眼（31.4%）。
MP - TSCP在大多数患者中成功控制了眼压，并减少了术后药物用量，同时眼内炎症和并发症最少。微脉冲手术也可重复进行。未来有必要在更大规模的患者群体中进行更长时间的评估，以研究有效的治疗参数。
