Threlkeld A B, Hertzmark E, Sturm R T, Epstein D L, Allingham R R
Medical College of Georgia, Augusta, USA.
J Glaucoma. 1996 Oct;5(5):311-6.
To investigate the efficacy of argon laser trabeculoplasty (ALT) for the treatment of primary open-angle glaucoma (POAG) and of glaucoma associated with exfoliation syndrome (EXF).
Review of > 200 charts from patients treated with ALT between 1981 and 1987 identified 66 POAG and 29 EXF eyes that underwent initial 180 degrees treatment. Variables including baseline intraocular pressure (IOP), age, sex, angle pigmentation, and follow-up IOP were studied with numerous statistical analyses. Multiple failure modes were used to define failure rate. All POAG and EXF patients were white.
The baseline pre-ALT IOP was 23.2 +/- 6.1 mm Hg for the POAG group and 25.8 +/- 5.9 mm Hg for the EXF group (p < .06). Mean follow-up time was 27 +/- 22 months for POAG eyes and 23 +/- 20 months for EXF eyes. Using failure mode 4 (glaucoma surgery, third laser, IOP < or = 22 mm Hg, or two consecutive IOPs > 85% of original baseline IOP), the 1-year failure rates were 40% (POAG) and 18% (EXF), and the 3-year rates were 58% (POAG) and 47% (EXF), p < 0.89 by log-rank test. A Cox proportional hazards model controlling for baseline IOP, age, sex, and angle pigmentation demonstrated that exfoliation status did not affect progression to filtering surgery (p > 0.60).
Using multiple failure modes, the results suggest that the success rate of ALT in exfoliation glaucoma tends to decrease over time, but then stabilizes at this reduced value at a level similar to that of POAG. By 3 years, there is a substantial failure rate in both POAG eyes and EXF eyes. Although the initial response to ALT in EXF patients is greater, the long-term outcome is similar for both groups.
研究氩激光小梁成形术（ALT）治疗原发性开角型青光眼（POAG）及剥脱综合征（EXF）相关性青光眼的疗效。
回顾1981年至1987年间接受ALT治疗的200余例患者的病历，确定66只POAG眼和29只EXF眼接受了初始180度治疗。通过多种统计分析研究包括基线眼压（IOP）、年龄、性别、房角色素沉着及随访眼压等变量。采用多种失败模式定义失败率。所有POAG和EXF患者均为白人。
POAG组ALT术前基线眼压为23.2±6.1 mmHg，EXF组为25.8±5.9 mmHg（p<0.06）。POAG眼平均随访时间为27±22个月，EXF眼为23±20个月。采用失败模式4（青光眼手术、第三次激光治疗、眼压≤22 mmHg或连续两次眼压>原始基线眼压的85%），1年失败率POAG组为40%，EXF组为18%；3年失败率POAG组为58%，EXF组为47%，对数秩检验p<0.89。控制基线眼压、年龄、性别和房角色素沉着的Cox比例风险模型显示，剥脱状态不影响向滤过手术进展（p>0.60）。
采用多种失败模式，结果表明ALT治疗剥脱性青光眼的成功率随时间推移趋于下降，但随后在这一降低值稳定在与POAG相似的水平。到3年时，POAG眼和EXF眼均有相当高的失败率。尽管EXF患者对ALT的初始反应更大，但两组的长期结果相似。
