Glaucoma Service, Wills Eye Hospital, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, 19107 PA, USA.
Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diegol, La Jolla, USA.
Eur J Ophthalmol. 2024 Nov;34(6):1957-1963. doi: 10.1177/11206721241237305. Epub 2024 Mar 12.
To compare the intraocular pressure (IOP) profile and the incidence of IOP spikes following selective laser trabeculoplasty (SLT) between pigmentary glaucoma (PG) and primary open-angle glaucoma (POAG).
Retrospective comparative study of 65 PG eyes of 51 patients matched with 65 POAG eyes of 65 patients who received SLT. Matching was done based on age, gender, glaucoma severity, pre-laser IOP, and number of medications. Post-SLT IOP spike was defined as IOP elevation ≥5mmHg, 30-45 min after the laser.
In PG and POAG groups, the average age was 62.33 ± 9.18 and 62.58 ± 9.19 years (p = 0.95). The glaucoma severity (p = 0.708), baseline IOP (PG = 21.61 ± 1.34mmHg vs. POAG = 21.13 ± 5.09mmHg, p = 0.943), and number of topical glaucoma medications(PG = 2.34 ± 1.34 vs. POAG = 2.1 ± 1.41, p = 0.342) were comparable. More PG patients were on oral acetazolamide (PG = 26.15% vs. POAG = 1.5%, p < 0.001). Average logMAR visual acuity was significantly higher in the POAG group (0.207 ± 0.3 vs. 0.192 ± 0.37, p = 0.012). Eyes with PG received lower laser energy (POAG = 63.65 ± 22.03 mJ vs. PG = 43.71 ± 25.68 mJ, p < 0.001). IOP spikes were recorded in 5 PG eyes (7.6%) and none in the POAG group (p = 0.058). Failure rates were similar (PG = 50.7% and POAG = 43.1%, p = 0.205). In multivariable analysis, only pre-laser IOP (coefficient = 2.154 [CI: 0.765-3.543], p = 0.003) was a significant predictor of IOP change percentage after 12 months.
SLT was comparably effective in both PG and POAG. IOP spikes were observed only in the PG group, though the total laser energy was lower in this group compared with POAG.
比较色素性青光眼（PG）和原发性开角型青光眼（POAG）患者行选择性激光小梁成形术（SLT）后的眼压（IOP）变化曲线和眼压升高的发生率。
回顾性对比研究，纳入了 51 名接受 SLT 的 PG 患者的 65 只眼和 65 名接受 SLT 的 POAG 患者的 65 只眼。基于年龄、性别、青光眼严重程度、激光前眼压和药物使用数量进行匹配。术后眼压升高定义为激光后 30-45 分钟眼压升高≥5mmHg。
PG 组和 POAG 组的平均年龄分别为 62.33±9.18 岁和 62.58±9.19 岁（p=0.95）。青光眼严重程度（p=0.708）、基线眼压（PG=21.61±1.34mmHg，POAG=21.13±5.09mmHg，p=0.943）和局部降眼压药物使用数量（PG=2.34±1.34，POAG=2.1±1.41，p=0.342）无显著差异。更多的 PG 患者口服乙酰唑胺（PG=26.15%，POAG=1.5%，p<0.001）。POAG 组平均 logMAR 视力明显更高（0.207±0.3，0.192±0.37，p=0.012）。PG 患者接受的激光能量更低（POAG=63.65±22.03mJ，PG=43.71±25.68mJ，p<0.001）。PG 组有 5 只眼（7.6%）出现眼压升高，POAG 组无一例眼压升高（p=0.058）。两组的失败率相似（PG=50.7%，POAG=43.1%，p=0.205）。多变量分析显示，只有激光前眼压（系数=2.154[CI：0.765-3.543]，p=0.003）是术后 12 个月眼压变化百分比的显著预测因子。
SLT 在 PG 和 POAG 中同样有效。PG 组仅观察到眼压升高，但与 POAG 相比，该组的总激光能量较低。
