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选择性激光小梁成形术后未治疗对侧眼的眼压反应

Intraocular Pressure Response in the Untreated Contralateral Eye After Selective Laser Trabeculoplasty.

作者信息

Dossantos Jason, Muser Tyler, Hill Devin, Lesche Stephen, Ahmed Aseef, Belyea David

机构信息

Department of Ophthalmology, George Washington University School of Medicine and Health Sciences, Washington, USA.

出版信息

Cureus. 2024 Aug 22;16(8):e67537. doi: 10.7759/cureus.67537. eCollection 2024 Aug.

Abstract

AIM

To examine the impact of selective laser trabeculoplasty (SLT) on intraocular pressure (IOP) in the untreated contralateral eye within 12 months after the procedure.

METHODS

A retrospective chart review was conducted on patients with primary open-angle, normal-tension, pigmentary, or pseudoexfoliation glaucoma who received 360-degree SLT at George Washington University. Exclusion criteria included prior or subsequent laser or glaucoma surgery within 12 months of SLT, other glaucoma types, or corticosteroid use during follow-up. Primary outcomes were IOP and medication reduction, and SLT success, defined as reducing IOP by ≥20% without additional IOP-lowering procedures or medications. Follow-up occurred at six weeks, six months, and 12 months. Demographic and clinical data were analyzed using ANOVA, paired t-tests, and chi-squared tests.

RESULTS

A total of 125 patients were included, representing a range of backgrounds: African American (57.6%), Caucasian (31.2%), Asian (5.6%), and Hispanic/Latino (4%), and 1.6% did not report their background. Significant reductions in mean IOP and medication numbers were observed in the contralateral eye at six weeks and six months (p<0.05) but not at 12 months. The contralateral eye success rates were 24% at six weeks and six months and 20.8% at 12 months. The contralateral eye was more likely to achieve success if the ipsilateral eye was successful at six weeks (odds ratio (95% confidence interval): 5.05 (1.89-13.48)), six months (16.1 (4.56-57.17)), and 12 months (5.94 (2.07-17.04)) (p<0.001 for all).

CONCLUSION

First-time SLT results in statistically significant IOP and medication reductions in the contralateral eye at six weeks and six months. The contralateral eye was 5.05-16.1 times more likely to achieve success if the ipsilateral eye was successful within 12 months.

摘要

目的

研究选择性激光小梁成形术(SLT)对手术12个月内未治疗的对侧眼眼压(IOP)的影响。

方法

对在乔治华盛顿大学接受360度SLT治疗的原发性开角型、正常眼压型、色素性或假性剥脱性青光眼患者进行回顾性病历审查。排除标准包括在SLT治疗前12个月内或之后进行过激光或青光眼手术、其他青光眼类型或随访期间使用皮质类固醇。主要结局指标为眼压和药物使用减少情况,以及SLT治疗成功,定义为眼压降低≥20%且无需额外的降眼压手术或药物。随访时间为6周、6个月和12个月。使用方差分析、配对t检验和卡方检验对人口统计学和临床数据进行分析。

结果

共纳入125例患者,背景各异:非裔美国人(57.6%)、白种人(31.2%)、亚洲人(5.6%)、西班牙裔/拉丁裔(4%),1.6%未报告其背景。对侧眼在6周和6个月时平均眼压和用药数量显著降低(p<0.05),但在12个月时未降低。对侧眼在6周和6个月时的成功率为24%,12个月时为20.8%。如果同侧眼在6周(优势比(95%置信区间):5.05(1.89 - 13.48))、6个月(16.1(4.56 - 57.17))和12个月(5.94(2.07 - 17.04))时成功,对侧眼更有可能成功(所有p<0.001)。

结论

首次SLT治疗在6周和6个月时可使对侧眼眼压和用药量在统计学上显著降低。如果同侧眼在12个月内成功,对侧眼成功的可能性高5.05至16.1倍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/348b/11343485/38fa8c129471/cureus-0016-00000067537-i01.jpg

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