Nutterová E, Pitrová Š, Lešták J
Cesk Slov Oftalmol. 2020 Winter;76(1):29-36. doi: 10.31348/2020/4.
The objective of this study was a retrospective assessment of two-year experience with micropulse cyclophotocoagulation (MP CPC) in the therapy of various types of glaucoma.
The cohort of patients consisted of 47 people, out of which 16 men and 31 women. An average age of males was 58.9 years (the range from 35 to 78 years), and an average age of females was 64.7 years (the range from 33 to 86 years). Both eyes were treated in three patients, and therefore the total number of assessed eyes was 50. Patients who underwent the therapy were in different stages of glaucoma disease, with various types of primary and secondary glaucoma. Most of the patients were those with primary open angle glaucoma (POAG): 26 patients, followed by patients with secondary pseudoexfoliative glaucoma (PEXG): 9 patients; diagnoses of the remaining patients: 4 patients - secondary pigmentary glaucoma (PG), 3 patients - primary angle closure glaucoma (PACG), 2 patients normal tension glaucoma (NTG), 3 patients - Posner-Schlossman syndrome, 1 patient - Cogan-Reese syndrome, 1 patient - neovascular glaucoma and 1 patient - secondary traumatic glaucoma. On the operated eye prior to the surgery 3 patients underwent laser iridotomy, 4 patients trabeculectomy, 4 patients EX-PRESS® implant, 3 patients EX-PRESS® implant and trabeculectomy and 1 patient transscleral cyclophotocoagulation. During surgery we opted for from 2,000 to 2,250 mW infrared laser with 810 nm wavelength which uses a micropulse system of laser energy emission. For the procedure we used a new MP3 application probe. 30% drop in intraocular pressure (IOP) compared to the baseline IOP values was set as a success.
Our results correlated with the most of available studies when we achieved drop in the values of intraocular pressure by the minimum of 30% in 53.4% of the eyes. The effect of therapy failed in 9 eyes (18%) where we subsequently selected a different therapeutic procedure.
MP CPC is a non-incisional laser treatment with minimum complications. It is characterized by a high safety profile and predictability of results. In our study we achieved drop in the values of intraocular pressure by the minimum of 30% in 53.4% of treated eyes. Its use is not limited by the type of glaucoma disease. In the event of insufficient effect, it may be repeated.
本研究的目的是对微脉冲睫状体光凝术(MP CPC)治疗各类青光眼的两年经验进行回顾性评估。
患者队列由47人组成,其中男性16人,女性31人。男性平均年龄为58.9岁(范围为35至78岁),女性平均年龄为64.7岁(范围为33至86岁)。3例患者双眼接受治疗,因此评估的眼睛总数为50只。接受治疗的患者处于青光眼疾病的不同阶段,包括各种类型的原发性和继发性青光眼。大多数患者为原发性开角型青光眼(POAG):26例,其次是继发性假性剥脱性青光眼(PEXG):9例;其余患者的诊断为:4例 - 继发性色素性青光眼(PG),3例 - 原发性闭角型青光眼(PACG),2例 - 正常眼压性青光眼(NTG),3例 - 波斯纳 - 施洛斯曼综合征,1例 - 科根 - 里斯综合征,1例 - 新生血管性青光眼和1例 - 继发性外伤性青光眼。手术前,3例患者在手术眼上进行了激光虹膜切开术,4例患者进行了小梁切除术,4例患者植入了EX-PRESS®,3例患者植入了EX-PRESS®并进行了小梁切除术,1例患者进行了经巩膜睫状体光凝术。手术期间,我们选择了波长为810nm、功率为2000至2250mW的红外激光,该激光采用微脉冲激光能量发射系统。对于该手术,我们使用了新型MP3应用探头。与基线眼压值相比,眼压降低30%被设定为成功。
当我们在53.4%的眼睛中使眼压值至少降低30%时,我们的结果与大多数现有研究相关。9只眼睛(18%)治疗效果不佳,随后我们选择了不同的治疗方法。
MP CPC是一种非侵入性激光治疗,并发症最少。它具有高度的安全性和结果可预测性。在我们的研究中,我们在53.4%的治疗眼中使眼压值至少降低了30%。其应用不受青光眼疾病类型的限制。如果效果不佳,可以重复使用。