Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, 625 S Fair Oaks Ave Suite 285, Pasadena, CA, 91105, USA.
Kresge Eye Institute, Department of Ophthalmology, School of Medicine, Wayne State University, Detroit, MI, USA.
Graefes Arch Clin Exp Ophthalmol. 2023 Oct;261(10):2935-2944. doi: 10.1007/s00417-023-06119-9. Epub 2023 May 29.
To evaluate the outcomes of micropulse transscleral laser therapy (MP-TLT) in patients with uncontrolled glaucoma and prior glaucoma aqueous tube shunt.
In this single‑center, retrospective, interventional case series, eyes that underwent MP-TLT and had prior glaucoma aqueous tube shunt surgeries were included. The Cyclo Glaucoma Laser System (IRIDEX Corporation, Mountain View, CA, USA) with the MicroPulse P3 probe (version 1) was used. Post‑operative data were collected at day 1, week 1, and months 1, 3, 6, 12, 18, 24, 30 and 36.
A total of 84 eyes (84 patients) with mean age of 65.8 ± 15.2 years and with advanced glaucoma (baseline mean deviation -16.25 ± 6.80 dB and best-corrected visual acuity 0.82 ± 0.83 logMar) were included in the study. Baseline mean IOP was 19.95 ± 5.6 mm Hg with a mean number of medications 3.39 ± 1.02. There were statistically significant differences in IOP between baseline and all follow-up visits (p < 0.01 for all). The mean percentage of IOP reduction between baseline and different follow-up visits ranged from 23.4% to 35.5% (p < 0.01). There was a significant reduction of visual acuity (≥ 2-lines) at 1 year (30.3%) and 2 years (76.78%). There was a statistically significant reduction in the number of glaucoma medications between baseline and all follow-up visits after postoperative week 1 (p < 0.05 for all). No severe complications including persistent hypotony and related complications were observed. At the last follow-up visit, only 24 (28%) eyes out of 84 eyes remained in the study.
MP-TLT is an effective treatment for reducing IOP and decreasing the number of medications in patients with advanced glaucoma and prior glaucoma aqueous tube shunt.
评估微脉冲经巩膜激光治疗（MP-TLT）在青光眼伴不可控性和先前青光眼房水引流管植入患者中的疗效。
本单中心回顾性干预性病例系列研究纳入了接受 MP-TLT 且先前行青光眼房水引流管植入术的患者。采用 Cyclo Glaucoma Laser System（IRIDEX Corporation，美国加利福尼亚州山景城）联合 MicroPulse P3 探头（第 1 代）进行治疗。术后第 1、1 周及 1、3、6、12、18、24、30 和 36 个月采集术后数据。
共纳入 84 只眼（84 例患者），平均年龄为 65.8±15.2 岁，均为晚期青光眼（基线平均偏差为-16.25±6.80 dB，最佳矫正视力为 0.82±0.83 logMar）。研究纳入时，平均眼压为 19.95±5.6 mm Hg，平均用药数为 3.39±1.02。与基线相比，所有随访时间点的眼压均有统计学意义的差异（所有时间点 p<0.01）。眼压从基线到不同随访时间点的平均降低百分比范围为 23.4%至 35.5%（所有时间点 p<0.01）。术后 1 年（30.3%）和 2 年（76.78%）时，视力（≥2 行）显著提高。与基线相比，术后第 1 周后所有随访时间点的青光眼药物数量均有统计学意义的减少（所有时间点 p<0.05）。未观察到严重并发症，包括持续性低眼压及相关并发症。末次随访时，84 只眼中仅有 24 只（28%）仍在研究中。
MP-TLT 是治疗晚期青光眼伴先前青光眼房水引流管植入患者的有效方法，可降低眼压并减少药物使用数量。
