经巩膜微脉冲激光疗法治疗青光眼患者。

MicroPulse® transscleral laser therapy in the management of glaucoma patients.

机构信息

Departamento de Oftalmología, Ain Shams University Hospitals, Ain Shams University, El Cairo, Egypt.

出版信息

Arch Soc Esp Oftalmol (Engl Ed). 2021 Dec;96(12):640-648. doi: 10.1016/j.oftale.2020.12.005. Epub 2021 May 21.

DOI:10.1016/j.oftale.2020.12.005

PMID:34844684

Abstract

PURPOSE

To evaluate the efficacy and safety of MicroPulse® transscleral laser therapy (TLT) in the management of glaucoma patients.

METHODS

A prospective, interventional, non-comparative case series was conducted in the department of ophthalmology, Ain Shams University Hospital on 61 eyes of 46 patients with various glaucoma types and of severity, ranging from mild to severe. In addition to best-corrected visual acuity (BCVA), intraocular pressure (IOP) and the number of glaucoma medications were recorded before and after treatment, along with the postoperative need for systemic carbonic anhydrase inhibitors (CAI), success rates, number of treatment sessions and postoperative complications. Success was defined as an IOP of 6-18 mmHg or at least a 30% decrease from preoperative IOP in the absence of any vision-threatening complications during the 6-month follow-up period.

RESULTS

MicroPulse TLT was performed on 61 glaucomatous eyes. Eleven of the 61 eyes (18%) that did not achieve IOP between 6-18 mmHg, or at least a 30% decrease from baseline at 6 months, had a repeat MicroPulse TLT session. At 6 months follow-up post a single MicroPulse TLT session, the mean IOP reduction was 35.9 ± 14.2%; and 6 months after the second session, it was 36.2 ± 17.5% (p < 0.001). The success rate after the first session was 73.8% which increased to 78.7% after the second session. The mean anterior chamber (AC) cell reaction was +1.9 ± 0.8 at 1 day, +1.0 ± 0.7 at 1 week, and +0.2 ± 0.4 at 1 month postoperatively. No cells were detected in any of the cases at 3 and 6 months follow-up (p < 0.001). The average number of anti-glaucoma eye drops before MicroPulse TLT was 2.6 ± 1.0. Postintervention, the average number of anti-glaucoma eye drops was 1.7 ± 1.2, and sustained at 6 months follow-up after the last treatment session (p < 0.001). There were no significant complications were noted. One eye developed transient hypotony for 3 months after MicroPulse TLT.

CONCLUSIONS

MicroPulse TLT is safe and effective in lowering IOP in a variety of glaucoma types and severity.

摘要

目的

评估微脉冲经巩膜激光治疗（TLT）在治疗青光眼患者中的疗效和安全性。

方法

在艾因夏姆斯大学医院眼科进行了一项前瞻性、干预性、非对照的病例系列研究，纳入了 46 名患者的 61 只眼，这些患者患有各种类型和严重程度的青光眼，从轻度到重度不等。除了最佳矫正视力（BCVA）、眼压（IOP）和青光眼药物数量外，还记录了治疗前后的情况，以及术后是否需要全身碳酸酐酶抑制剂（CAI）、成功率、治疗次数和术后并发症。成功定义为眼压在 6-18mmHg 之间，或在 6 个月的随访期间没有任何威胁视力的并发症时，与术前眼压相比至少降低 30%。

结果

对 61 只青光眼眼进行了微脉冲 TLT。在 6 个月的随访中，有 11 只眼（18%）的眼压未达到 6-18mmHg，或与基线相比至少降低 30%，需要再次进行微脉冲 TLT 治疗。单次微脉冲 TLT 治疗 6 个月后，平均眼压降低 35.9±14.2%；第二次治疗后 6 个月，平均眼压降低 36.2±17.5%（p<0.001）。第一次治疗的成功率为 73.8%，第二次治疗后增加到 78.7%。第一次治疗后 1 天平均前房细胞反应为+1.9±0.8，第 1 周为+1.0±0.7，第 1 个月为+0.2±0.4。在第 3 和第 6 个月的随访中，任何病例均未检测到细胞（p<0.001）。微脉冲 TLT 前平均使用抗青光眼眼药水 2.6±1.0 滴。治疗后，平均使用抗青光眼眼药水 1.7±1.2 滴，在最后一次治疗后 6 个月的随访中保持不变（p<0.001）。未发现明显并发症。1 只眼在微脉冲 TLT 后 3 个月出现短暂性低眼压。