Chang Hsiao-Ling, Chao Shih-Chun, Lee Ming-Tsung, Lin Hung-Yu
Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua 500, Taiwan.
Department of Optometry, Central Taiwan University of Science and Technology, Taichung 406, Taiwan.
Healthcare (Basel). 2021 Nov 17;9(11):1563. doi: 10.3390/healthcare9111563.
Glaucoma is the leading cause of irreversible blindness worldwide, with primary open angle glaucoma (POAG) accounting for the greatest number of total glaucoma cases. This study aimed to evaluate the efficacy and safety of micropulse transscleral cyclophotocoagulation (MP-TSCPC) as a primary procedure in POAG during the COVID-19 pandemic. We retrospectively analyzed 60 eyes of 52 patients, who were diagnosed with mild-to-end-stage POAG without previous glaucoma surgery and received MP-TSCPC between 1 January 2020 and 31 August 2020. The mean preoperative intraocular pressure (IOP) significantly decreased from 27.8 mm Hg to 19.8, 20.1, 20.3, 20.4, and 20.2 mm Hg at 1, 3, 6, 9, and 12 months, respectively (all < 0.05). The mean number of IOP-lowering medications used significantly decreased from 3.3 at the baseline to 1.6, 1.8, 1.8, 1.9, and 1.9 at 1, 3, 6, 9, and 12 months, respectively (all < 0.001). Total withdrawal of antiglaucoma medications was fulfilled in five patients. The main outcome was achieved in 81.7% at postoperative month 12. The most common adverse effect was transient mydriasis (28.3%). No major complications were encountered. MP-TSCPC seems to be an effective and safe treatment to reduce IOP and the medication burden with minimal vision-threatening complications in mild-to-end-stage POAG patients without previous glaucoma surgery.
青光眼是全球不可逆性失明的主要原因,其中原发性开角型青光眼(POAG)占青光眼病例总数的最大比例。本研究旨在评估在2019年冠状病毒病(COVID-19)大流行期间,微脉冲经巩膜睫状体光凝术(MP-TSCPC)作为POAG的主要治疗方法的有效性和安全性。我们回顾性分析了52例患者的60只眼,这些患者被诊断为轻度至晚期POAG,且既往未接受过青光眼手术,并于2020年1月1日至2020年8月31日接受了MP-TSCPC治疗。术前平均眼压(IOP)从27.8 mmHg分别显著降至术后1、3、6、9和12个月时的19.8、20.1、20.3、20.4和20.2 mmHg(均P<0.05)。使用的降眼压药物平均数量从基线时的3.3种分别显著降至术后1、3、6、9和12个月时的1.6、1.8、1.8、1.9和1.9种(均P<0.001)。5例患者完全停用了抗青光眼药物。术后12个月时,主要治疗终点达成率为81.7%。最常见的不良反应是短暂性瞳孔散大(28.3%)。未发生重大并发症。对于既往未接受过青光眼手术的轻度至晚期POAG患者,MP-TSCPC似乎是一种有效且安全的治疗方法,可降低眼压和药物负担,同时将视力威胁性并发症降至最低。