选择性激光小梁成形术治疗原发性开角型青光眼和高眼压症年轻患者的疗效
Outcome of Selective Laser Trabeculoplasty in Young Patients with Primary Open-Angle Glaucoma and Ocular Hypertension.
作者信息
Liu Dan, Chen Di, Tan Qian, Xia Xiaobo, Jiang Haibo, Jiang Jian
机构信息
Eye Center of Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, China.
Hunan Key Laboratory of Ophthalmology, 87 Xiangya Road, Changsha, China.
出版信息
J Ophthalmol. 2020 Jun 9;2020:5742832. doi: 10.1155/2020/5742832. eCollection 2020.
PURPOSE
To determine the effectiveness and safety of selective laser trabeculoplasty (SLT) in young patients with primary open-angle glaucoma (POAG) and ocular hypertension (OHT).
METHODS
This was a retrospective clinical study. Fifty-six eyes from 56 young (age ≤ 40 y) patients with POAG or OHT treated with SLT were included. According to age, patients were divided into group 1 and group 2. Patients in group 1 were younger than 18 years old, and patients in group 2 were between 18 and 40 years old. Patients were evaluated before treatment and at 1 hour, 1 day, 1 week, 1 month, 3 months, 6 months, and 1 year after treatment. We also collected older patients (age ≥ 60 y) who received SLT during the same period for comparison at 1-year follow-up. Possible factors affecting the success of SLT, including baseline IOP, age, sex, diagnosis (POAG or OHT), and whether or not use of antiglaucoma medication before treatment, were analyzed.
RESULTS
SLT treatment produced significant reduction in IOP in the young patients with POAG or OHT during the 1-year follow-up period（ < 0.05）. Mean IOP at 1 hour after SLT was lower in group 1 than in group 2 ( < 0.01), but at other follow-up time points, IOP values were not different ( > 0.05). IOP reduction and success rate were not significantly different between young and old patients at 1 year after treatment. IOP measurements over a 24-hour period were recorded before and after the SLT in 20 young adult patients. IOP values were significantly lower in the treated patients at all time points than at pretreatment ( < 0.05), and 24-hour mean IOP, peak IOP, valley IOP, and fluctuation in IOP were also lower in SLT-treated patients ( < 0.05). Baseline IOP was found as a predictor of SLT success in young patients (OR = 1.895, =0.003), whereas age, gender, diagnosis, and whether or not use of antiglaucoma medication were not correlated with SLT success (=0.725, =0.750, =0.061, and =0.201, respectively).
CONCLUSION
In this study, SLT was found as an effective and safe treatment for young patients with POAG and OHT. High baseline IOP predicted high SLT success.
目的
确定选择性激光小梁成形术（SLT）治疗原发性开角型青光眼（POAG）和高眼压症（OHT）年轻患者的有效性和安全性。
方法
这是一项回顾性临床研究。纳入了56例接受SLT治疗的POAG或OHT年轻患者（年龄≤40岁）的56只眼。根据年龄，患者分为1组和2组。1组患者年龄小于18岁，2组患者年龄在18至40岁之间。在治疗前以及治疗后1小时、1天、1周、1个月、3个月、6个月和1年对患者进行评估。我们还收集了同期接受SLT治疗的老年患者（年龄≥60岁），以便在1年随访时进行比较。分析了可能影响SLT成功的因素，包括基线眼压、年龄、性别、诊断（POAG或OHT）以及治疗前是否使用抗青光眼药物。
结果
在1年随访期内，SLT治疗使POAG或OHT年轻患者的眼压显著降低（P<0.05）。SLT后1小时，1组的平均眼压低于2组（P<0.01），但在其他随访时间点，眼压值无差异（P>0.05）。治疗1年后，年轻患者和老年患者的眼压降低情况及成功率无显著差异。对20例年轻成年患者在SLT前后记录了24小时眼压测量值。治疗后所有时间点的眼压值均显著低于治疗前（P<0.05），SLT治疗患者的24小时平均眼压、眼压峰值、眼压谷值及眼压波动也较低（P<0.05）。发现基线眼压是年轻患者SLT成功的预测指标（OR = 1.895，P = 0.003），而年龄、性别、诊断以及是否使用抗青光眼药物与SLT成功无关（P分别为0.725、0.750、0.061和0.201）。
结论
在本研究中，发现SLT是治疗POAG和OHT年轻患者的有效且安全的方法。高基线眼压预示着SLT成功率高。
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