Makri Olga E, Pallikari Athina, Pagoulatos Dionysios, Kagkelaris Konstantinos, Kostopoulou Elli V, Georgakopoulos Constantinos D
Department of Ophthalmology, University of Patras, Medical School, 265 04, Patras, Greece.
Graefes Arch Clin Exp Ophthalmol. 2019 Feb;257(2):349-355. doi: 10.1007/s00417-018-4195-2. Epub 2018 Nov 28.
To evaluate the effectiveness of a single session of micropulse laser trabeculoplasty (MLT) to lower intraocular pressure (IOP) in patients with pseudoexfoliation glaucoma (PEXG).
In this single-center, one-arm, prospective study patients with PEXG under prostaglandine analogue monotherapy with inadequate IOP control were treated with 360° 532-nm MLT. Patients were evaluated at 1 day, 1 month, 3 months, 6 months, and 12 months post-MLT while they were treated with the same drug regimen as pre-MLT. Mean IOP reduction and percentage of IOP change during the follow-up were calculated. Cases that required any further intervention, like additional hypotensive medication, laser or surgical therapy, throughout the study period were considered failures and removed from the study.
Twenty-seven eyes (27 patients, 17 male) were included in the study. The age of the patients was 72.37 ± 6.29 years and the baseline IOP was 20.41 ± 1.87 mmHg. Treatment with MLT resulted in significantly lower IOP at 1, 3, 6, and 12 months after MLT compared to baseline (p < 0.0001 for all comparisons). By the end of the study, 52.17% of the PEXG eyes demonstrated a ≥ 20% IOP reduction compared to baseline. Four eyes (14.81%) did not respond to MLT (three eyes at 3 months and one eye at 6 months after trabeculoplasty) and were considered failures since they required additional intervention.
Micropulse laser trabeculoplasty appears to be an effective method to lower IOP in patients with PEXG up to 12 month of follow-up period.
The study is registered on www.ClinicalTrials.gov with registration number NCT03483402.
评估单次微脉冲激光小梁成形术(MLT)降低剥脱性青光眼(PEXG)患者眼压(IOP)的有效性。
在这项单中心、单臂、前瞻性研究中,对使用前列腺素类似物单一疗法但眼压控制不佳的PEXG患者进行360°532纳米MLT治疗。在MLT术后1天、1个月、3个月、6个月和12个月对患者进行评估,期间他们接受与MLT术前相同的药物治疗方案。计算随访期间平均眼压降低值和眼压变化百分比。在整个研究期间需要任何进一步干预(如额外的降压药物、激光或手术治疗)的病例被视为治疗失败并排除在研究之外。
27只眼(27例患者,17例男性)纳入研究。患者年龄为72.37±6.29岁,基线眼压为20.41±1.87 mmHg。与基线相比,MLT治疗后1、3、6和12个月时眼压显著降低(所有比较p<0.0001)。到研究结束时,52.17%的PEXG眼与基线相比眼压降低≥20%。4只眼(14.81%)对MLT无反应(小梁成形术后3个月3只眼,6个月1只眼),由于需要额外干预被视为治疗失败。
微脉冲激光小梁成形术似乎是一种在长达12个月的随访期内降低PEXG患者眼压的有效方法。