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比较缓慢凝血经巩膜睫状体光凝术与微脉冲经巩膜激光睫状体光凝术的治疗效果。

Comparison of treatment outcomes between slow coagulation transscleral cyclophotocoagulation and micropulse transscleral laser treatment.

机构信息

Central Seoul Eye Center, Ichon-ro 224, Yongsan-gu, Seoul, Republic of Korea.

出版信息

Sci Rep. 2024 Oct 13;14(1):23944. doi: 10.1038/s41598-024-75246-y.

Abstract

This study compared treatment outcomes of slow coagulation transscleral cyclophotocoagulation (SC-CPC, 65 eyes) and micropulse transscleral laser treatment (MPL, 134 eyes) in patients with medically uncontrolled glaucoma. Success was defined as achieving an intraocular pressure (IOP) of 6-21 mmHg with a ≥ 20% reduction from baseline, no reoperation for glaucoma, and no loss of light-perception vision. Visual acuity, number of glaucoma medication, corneal endothelial cell count, aqueous flare values, and complications were analyzed. At 12 months, mean IOP decreased from 32.2 ± 13.4 to 17.9 ± 8.3 mmHg in the SC-CPC group and from 26.4 ± 10.8 to 16.5 ± 6.8 mmHg in the MPL group. No significant changes were observed in visual acuity, medication count, or corneal endothelial cell count. Aqueous flare values increased immediately after the procedure and gradually decreased in both groups, with greater changes at 1 week significantly associated with greater IOP reduction (p < 0.05). Pupillary abnormalities were found in 5 eyes (4.5%) of the MPL group, with no severe complications. The 12-month success rates were 50.1% for SC-CPC and 38.2% for MPL (p = 0.131). Both SC-CPC and MPL effectively controlled IOP, with early postoperative aqueous flare values predicting treatment outcomes.

摘要

本研究比较了慢凝血经巩膜睫状体光凝术(SC-CPC,65 只眼)和微脉冲经巩膜激光治疗(MPL,134 只眼)在药物控制不佳的青光眼患者中的治疗效果。成功定义为眼压(IOP)降至 6-21mmHg,与基线相比降低≥20%,无需再次行青光眼手术,且无光感丧失。分析视力、青光眼药物使用次数、角膜内皮细胞计数、房水闪辉值和并发症。在 12 个月时,SC-CPC 组的平均 IOP 从 32.2±13.4mmHg 降至 17.9±8.3mmHg,MPL 组从 26.4±10.8mmHg 降至 16.5±6.8mmHg。视力、药物使用次数或角膜内皮细胞计数无明显变化。房水闪辉值在手术后立即升高,两组均逐渐下降,术后 1 周时变化更大与 IOP 降低更显著相关(p<0.05)。MPL 组有 5 只眼(4.5%)出现瞳孔异常,无严重并发症。SC-CPC 和 MPL 的 12 个月成功率分别为 50.1%和 38.2%(p=0.131)。SC-CPC 和 MPL 均可有效控制 IOP,术后早期房水闪辉值可预测治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61d0/11471840/abe7a5d723de/41598_2024_75246_Fig1_HTML.jpg

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