Magacho Leopoldo, Lima Francisco E, Ávila Marcos P
Ophthalmology Department, Federal University of Goiás (CEROF-HC-UFG), Avenida Americano do Brasil, 260, Setor Marista, Goiânia, GO, 74180-010, Brazil.
Hospital VER-Excelência em Oftalmologia, Goiânia, GO, Brazil.
Lasers Med Sci. 2020 Sep;35(7):1469-1475. doi: 10.1007/s10103-019-02922-1. Epub 2019 Dec 4.
This study aims to evaluate the effectiveness and safety of double-session micropulse transscleral (MP3) laser for the treatment of glaucoma. This was a retrospective chart review of all patients who underwent MP3 laser with the standard protocol and were within at least 12 months of their follow-up appointments. Eyes were treated at 2000 mW with 31.3% duty cycle for 80 s per treatment session, with double sessions in each hemifield alternating between upper and lower and upper and lower. Success criterion was defined as a greater than 20% reduction in intraocular pressure (IOP) and an IOP between 6 and 18 mmHg at the end of the follow-up period. Eighty-nine eyes of seventy-six glaucoma patients were included; 31 of which were considered primary, i.e., no previous glaucoma surgery. The average pre-treatment IOP was 29.9 ± 6.4 mmHg. At around 16.7 ± 3.1 months of follow-up, the average IOP was 14.8 ± 4.7 mmHg (p < 0.001) (28.8 ± 7.4 to 15.7 ± 5.3 mmHg, p < 0.001, at 17.0 ± 3.1 months in the primary eyes). The number of topical glaucoma medications was reduced from 3.6 ± 0.5 to 1.9 ± 0.9 at the last evaluation (p < 0.001). The best corrected visual acuity in logMAR ranged from 0.41 ± 0.34 preoperatively to 0.45 ± 0.44 at the last visit (p = 0.2), and also remained stable in primary eyes. Success was obtained in 86.5% of the eyes, with 1.5 ± 0.8 procedures, and in 90.3% with 1.2 ± 0.5 MP3 laser procedures in the primary eye group. MP3 laser in two consecutive 80-s sessions was shown to be safe and effective in the treatment of glaucoma. Primary eyes required lower number of MP3 laser procedures.
本研究旨在评估双疗程微脉冲经巩膜（MP3）激光治疗青光眼的有效性和安全性。这是一项回顾性图表审查研究，纳入了所有按照标准方案接受MP3激光治疗且随访时间至少为12个月的患者。每次治疗时，以2000毫瓦、31.3%的占空比，每次治疗80秒对眼睛进行治疗，每个半视野分上下两个区域交替进行双疗程治疗。成功标准定义为随访期结束时眼压（IOP）降低超过20%且眼压在6至18 mmHg之间。纳入了76例青光眼患者的89只眼睛；其中31只被视为原发性青光眼，即未曾接受过青光眼手术。治疗前平均眼压为29.9±6.4 mmHg。在随访约16.7±3.1个月时，平均眼压为14.8±4.7 mmHg（p < 0.001）（原发性青光眼在17.0±3.1个月时，眼压从28.8±7.4 mmHg降至15.7±5.3 mmHg，p < 0.001）。在最后一次评估时，局部青光眼药物的使用数量从3.6±0.5减少至1.9±0.9（p < 0.001）。最佳矫正视力的logMAR值从术前的0.41±0.34提高到最后一次就诊时的0.45±0.44（p = 0.2），在原发性青光眼患者中视力也保持稳定。86.5%的眼睛治疗成功，平均进行1.5±0.8次治疗；在原发性青光眼组中，90.3%的眼睛通过平均1.2±0.5次MP3激光治疗获得成功。连续两个80秒疗程的MP3激光治疗青光眼安全有效。原发性青光眼所需的MP3激光治疗次数较少。
