Department of Ophthalmology, HanGil Eye Hospital, Incheon, Korea.
Department of Ophthalmology, Catholic Kwandong University College of Medicine, Incheon, Korea.
Korean J Ophthalmol. 2021 Dec;35(6):476-483. doi: 10.3341/kjo.2021.0086. Epub 2021 Oct 12.
This study investigated the efficacy and safety of selective laser trabeculoplasty (SLT) in Korean patients with medically uncontrolled pseudoexfoliation glaucoma (PEXG).
This retrospective observational study enrolled 43 medically uncontrolled PEXG patients who underwent a 360° SLT and were followed up for at least 12 months after SLT. The intraocular pressure (IOP) before and after SLT at 1 week, 1, 3, 6, and 12 months was evaluated. Treatment success was defined as an IOP reduction of ≥20% from the baseline and an IOP equal to lower than 22 mmHg without additional anti-glaucomatous intervention. Additionally, every follow-up medical record was reviewed to assess any possible side effects of SLT.
Based on the Kaplan-Meier survival analysis, the treatment success rate at 12 months after SLT was 41.9% (18 eyes). For the success group at the 12 months follow-up, SLT showed a mean IOP reduction of 10.3 ± 5.0 mmHg (from 25.6 ± 4.4 to 15.2 ± 2.9 mmHg; 39.3%, p < 0.05). Among the 25 eyes that were considered as the treatment failure group, 14 eyes underwent glaucoma filtering surgeries, four eyes received additional SLT, and further intervention and follow-up was refused for seven eyes. During the overall follow-up period, there were no significant adverse events.
SLT is a partially effective and safe procedure for lowering IOP in Korean patients with medically refractory PEXG. Therefore, it can be considered as one of the alternative treatment modalities in patients who are at high risk for conventional filtering surgery.
本研究旨在探讨选择性激光小梁成形术(SLT)治疗药物控制不佳的原发性开角型青光眼(PEXG)的疗效和安全性。
本回顾性观察研究纳入了 43 例药物控制不佳的 PEXG 患者,所有患者均接受了 360° SLT 治疗,并在 SLT 后至少随访 12 个月。评估 SLT 前后 1 周、1、3、6 和 12 个月的眼压(IOP)。治疗成功定义为眼压较基线下降≥20%,且无需进一步抗青光眼治疗,眼压即等于或低于 22mmHg。此外,还对每次随访的医疗记录进行了回顾,以评估 SLT 的任何潜在不良反应。
基于 Kaplan-Meier 生存分析,SLT 治疗后 12 个月的治疗成功率为 41.9%(18 只眼)。在 12 个月随访时的成功组中,SLT 显示平均眼压降低 10.3 ± 5.0mmHg(从 25.6 ± 4.4mmHg 降至 15.2 ± 2.9mmHg;39.3%,p<0.05)。在被认为是治疗失败组的 25 只眼中,14 只眼接受了青光眼滤过性手术,4 只眼接受了额外的 SLT,7 只眼因拒绝进一步干预和随访而未接受治疗。在整个随访期间,未发生明显的不良反应事件。
SLT 是一种降低药物难治性 PEXG 韩国患者眼压的部分有效且安全的方法。因此,对于那些有传统滤过性手术高风险的患者,它可以被视为一种替代治疗方法。