Nirappel Abraham, Klug Emma, Ye Rebecca, Hall Nathan, Chachanidze Marika, Chang Ta C, Solá-Del Valle David
Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
J Ophthalmol. 2021 Feb 16;2021:8860601. doi: 10.1155/2021/8860601. eCollection 2021.
To compare the effectiveness and safety of 360° and 180° of Selective Laser Trabeculoplasty (SLT) for the treatment of elevated intraocular pressure (IOP).
Retrospective cohort study. The main outcome measure was the Kaplan-Meier analysis comparing the cumulative probabilities of survival between the 360° and 180° SLT groups in terms of IOP reduction. Success was defined as ≥20% IOP reduction from baseline with an IOP between 5-18 mmHg and ≤1 glaucoma medication added postoperatively. Additional outcome measures included changes in average IOP, number of glaucoma medications, and the incidence of postoperative IOP spikes. Measurements were obtained at 6 weeks, 1 year, and 2 years postoperatively.
Two hundred and fifty-eight eyes of 258 patients were included in the 360° group, and 196 eyes of 196 patients were included in the 180° group. The mean IOP reductions at 2 years were 2.21 ± 2.02 mmHg and 2.43 ± 1.81 mmHg (=0.33) in the 180° and 360° groups, respectively. There were no significant differences in the incidence of postoperative IOP spikes between the two groups. There was a significant difference in the survival curves of the two groups (=0.035). The Cox proportional-hazard model indicated that 360° of SLT application was a significant predictor of long-term success (=0.030).
360° of SLT application seems to provide for greater long-term IOP control than 180° of application without putting patients at an elevated risk for postoperative IOP spikes.
比较360°和180°选择性激光小梁成形术（SLT）治疗眼压升高的有效性和安全性。
回顾性队列研究。主要观察指标是采用Kaplan-Meier分析比较360°和180°SLT组眼压降低方面的累积生存概率。成功定义为眼压从基线降低≥20%，眼压在5 - 18 mmHg之间，且术后添加≤1种青光眼药物。其他观察指标包括平均眼压变化、青光眼药物数量以及术后眼压峰值的发生率。在术后6周、1年和2年进行测量。
360°组纳入258例患者的258只眼，180°组纳入196例患者的196只眼。180°组和360°组2年时的平均眼压降低分别为2.21±2.02 mmHg和2.43±1.81 mmHg（P = 0.33）。两组术后眼压峰值的发生率无显著差异。两组的生存曲线有显著差异（P = 0.035）。Cox比例风险模型表明，360°SLT应用是长期成功的显著预测因素（P = 0.030）。
360°SLT应用似乎比180°应用能提供更好的长期眼压控制，且不会使患者术后眼压峰值风险升高。
