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微脉冲经巩膜激光治疗硅油相关性青光眼的疗效和安全性。

Efficacy and Safety of Micropulse Transscleral Laser Therapy in Silicone Oil-induced Glaucoma.

机构信息

Ophthalmology Department, Mohamed Taher Maamouri Hospital, Faculty of Medicine, Tunis El Manar, Tunisia.

出版信息

J Glaucoma. 2022 Aug 1;31(8):689-693. doi: 10.1097/IJG.0000000000002051. Epub 2022 May 10.

Abstract

PURPOSE

The purpose of this study was to assess the efficiency and safety of micropulse transscleral laser therapy (MP-TLT) in the management of silicone oil-induced glaucoma (SOG).

METHODS

A prospective case series of 33 eyes with uncontrolled SOG was enrolled at the Department of Ophthalmology of Mohamed Taher Maamouri Hospital, Nabeul, Tunisia. Patients were treated with MP-TLT using the IRIDEX Cyclo G6 Glaucoma Laser System with the MicroPulse P3 fiberoptic handheld probe. Patients underwent complete ophthalmologic examination during the 12-month follow-up period.

RESULTS

The study included 33 eyes of 33 patients. The mean age was 50.39 years old. We included patients with SOG. Silicone oil tamponade was indicated for complicated rhegmatogenous retinal detachment in 22 cases, diabetic tractional retinal detachment in 10 cases, and posttraumatic retinal detachment in 1 case. Silicone oil was already removed before the procedure in 23 eyes. Silicone oil tamponade duration varied between 3 and 26 months. Intraocular pressure (IOP) measurements at enrollment; days 1, 7, and 15; and months 1, 3, 6, and 12 was respectively 37.94±13.61, 19.03±10.98, 16.5±6.17, 19.45±9.73, 19.27±8.33, 19.39±9.52, 19.97±10.03, and 19.7±9.58 mm Hg. The percentage of IOP lowering was 45.38% at 6 months and 45% at 12 months. The success rate was 93.93% at 6 months, remaining stable at 12 months. No major side effects were observed, in particular, no phthisis bulbi nor prolonged inflammation. There was no difference in IOP lowering between patients with silicone oil or those after silicone oil removal ( P =0.99).

CONCLUSIONS

MP-TLT was safe and effectively lowered IOP in uncontrolled SOG.

摘要

目的

本研究旨在评估微脉冲经巩膜激光治疗(MP-TLT)在硅油性青光眼(SOG)治疗中的有效性和安全性。

方法

在突尼斯纳布勒的穆罕默德·塔赫尔·马穆里医院眼科,我们进行了一项前瞻性病例系列研究,共纳入 33 只患有未控制 SOG 的眼。使用 IRIDEX Cyclo G6 青光眼激光系统和微脉冲 P3 光纤手持探头对患者进行 MP-TLT 治疗。在 12 个月的随访期间,患者接受了全面的眼科检查。

结果

本研究共纳入 33 只眼 33 例患者。平均年龄为 50.39 岁。我们纳入的患者患有 SOG。硅油填充是为 22 例复杂性孔源性视网膜脱离、10 例糖尿病牵拉性视网膜脱离和 1 例外伤性视网膜脱离而进行的。23 只眼在手术前已将硅油取出。硅油填充时间为 3 至 26 个月。入组时、第 1、7 和 15 天以及第 1、3、6 和 12 个月的眼压测量值分别为 37.94±13.61、19.03±10.98、16.5±6.17、19.45±9.73、19.27±8.33、19.39±9.52、19.97±10.03 和 19.7±9.58mm Hg。第 6 个月时眼压降低率为 45.38%,第 12 个月时为 45%。第 6 个月时的成功率为 93.93%,第 12 个月时保持稳定。未观察到严重的不良反应,特别是没有眼球萎缩或炎症迁延。有硅油和硅油取出后的患者的眼压降低没有差异(P=0.99)。

结论

MP-TLT 治疗未控制 SOG 安全有效,可降低眼压。

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