Fisabio Oftalmologia Medica, Valencia, Spain.
Eur J Ophthalmol. 2021 May;31(3):1107-1112. doi: 10.1177/1120672120914230. Epub 2020 Mar 31.
Evaluate the efficacy of transscleral cyclophotocoagulation versus endoscopic cyclophotocoagulation to reduce intraocular pressure.
A retrospective, non-randomized cohort study with 1 year of follow-up included 62 eyes of 62 refractory glaucoma patients who underwent transscleral cyclophotocoagulation or endoscopic cyclophotocoagulation.
Thirty-two patients were enrolled in transscleral cyclophotocoagulation group and 30 patients in endoscopic cyclophotocoagulation group, and the follow-up period was 1 year. The mean preoperative intraocular pressure was 35.6 ± 12.9 mm Hg in the transscleral cyclophotocoagulation group and 31.8 ± 8.8 mm Hg in the endoscopic cyclophotocoagulation group without significant difference ( = 0.18). When we compare both groups, there was no difference at 1 month ( = 0.46) and 3 months ( = 0.21) after surgery. However, there was a statistically significant difference at month 6 ( = 0.0055) and 1 year ( = 0.0019), finding lower intraocular pressure in the transscleral cyclophotocoagulation group. Cumulative success for intraocular pressure <21 mm Hg was 93.8% in transscleral cyclophotocoagulation group and 83.3% in endoscopic cyclophotocoagulation group after 1 year ( = 0.2). For intraocular pressure <18 mm Hg, the success rate was 78.1% in transscleral cyclophotocoagulation group and 63.3% in endoscopic cyclophotocoagulation group ( = 0.06), and for intraocular pressure <16 mm Hg, the success rate was 62.5% in transscleral cyclophotocoagulation group and 43.3% in endoscopic cyclophotocoagulation group ( = 0.02). Hypotony ( = 0.01) and vision loss of two lines ( = 0.01) were statistically significant lower in endoscopic cyclophotocoagulation group.
This study demonstrates that both transscleral cyclophotocoagulation and endoscopic cyclophotocoagulation are effective at decreasing intraocular pressure. However, transscleral cyclophotocoagulation is related to more complications than endoscopic cyclophotocoagulation, whereas endoscopic cyclophotocoagulation shows lower intraocular pressure decrease than transscleral cyclophotocoagulation.
评估经巩膜睫状体光凝术与经内镜睫状体光凝术降低眼内压的疗效。
本研究为回顾性、非随机队列研究，随访时间为 1 年，共纳入 62 例难治性青光眼患者的 62 只眼，这些患者分别接受了经巩膜睫状体光凝术或经内镜睫状体光凝术治疗。
32 例患者纳入经巩膜睫状体光凝术组，30 例患者纳入经内镜睫状体光凝术组，随访时间为 1 年。经巩膜睫状体光凝术组术前平均眼压为 35.6±12.9mmHg，经内镜睫状体光凝术组为 31.8±8.8mmHg，两组间差异无统计学意义（P=0.18）。术后 1 个月（P=0.46）和 3 个月（P=0.21），两组间差异无统计学意义。然而，术后 6 个月（P=0.0055）和 1 年（P=0.0019）时，经巩膜睫状体光凝术组的眼压明显更低，差异有统计学意义。术后 1 年，经巩膜睫状体光凝术组眼压<21mmHg 的累积成功率为 93.8%，经内镜睫状体光凝术组为 83.3%（P=0.2）。经巩膜睫状体光凝术组眼压<18mmHg 的成功率为 78.1%，经内镜睫状体光凝术组为 63.3%（P=0.06）；经巩膜睫状体光凝术组眼压<16mmHg 的成功率为 62.5%，经内镜睫状体光凝术组为 43.3%（P=0.02）。经内镜睫状体光凝术组出现低眼压（P=0.01）和视力下降两行（P=0.01）的比例明显更低。
本研究表明，经巩膜睫状体光凝术和经内镜睫状体光凝术均能有效降低眼内压。然而，与经内镜睫状体光凝术相比，经巩膜睫状体光凝术相关并发症更多，而经内镜睫状体光凝术的眼压下降幅度更小。
