Wong E Y, Chew P T, Chee C K, Wong J S
Department of Ophthalmology, National University Hospital, Singapore.
Am J Ophthalmol. 1997 Dec;124(6):797-804. doi: 10.1016/s0002-9394(14)71697-6.
To evaluate the effectiveness and safety of diode laser contact transscleral cyclophotocoagulation in Asian patients with refractory glaucoma by lower energy settings with an innovative probe featuring a glass ball tip that focused the laser beam onto the ciliary body.
This prospective clinical study included consecutive Asian patients with dark irides and confirmed for glaucoma. Only one eye of each patient was treated. Diode laser contact transscleral cyclophotocoagulation treatment was performed with the center of the probe placed 1.5 mm behind the limbus. About 30 pulses of 810-mm laser radiation (power, 1.8 to 2.0 W; duration, 0.3 to 0.5 second) were applied around the eye. Patients were examined at fixed postoperative intervals. Intraocular pressure levels and postoperative complications were recorded. The relation between patient and disease characteristics, total laser energy delivered, and intraocular pressure effects were analyzed.
Thirty-three patients were studied, with a mean follow-up period of 9.4 months. An average 56% of patients showed a 30% or greater drop in intraocular pressure. About 38% of patients achieved sustained intraocular pressure lowering to below 22 mm Hg at 18 months. Complications were few and included transient hypotony and iritis.
In Asian patients with refractory glaucoma or painful glaucomatous eyes with poor visual acuity (defined for this study as worse than 20/200), low-energy-setting diode laser contact transscleral cyclophotocoagulation by means of the glass ball probe is relatively effective and safe.
通过采用一种创新的带有玻璃球尖端的探头将激光束聚焦到睫状体上的低能量设置，评估二极管激光接触式经巩膜睫状体光凝术在亚洲难治性青光眼患者中的有效性和安全性。
这项前瞻性临床研究纳入了连续的亚洲黑虹膜且确诊为青光眼的患者。每位患者仅一只眼睛接受治疗。进行二极管激光接触式经巩膜睫状体光凝术时，将探头中心置于角膜缘后1.5毫米处。在眼睛周围施加约30个脉冲的810纳米激光辐射（功率1.8至2.0瓦；持续时间0.3至0.5秒）。术后按固定间隔对患者进行检查。记录眼压水平和术后并发症。分析患者和疾病特征、总激光能量传递与眼压效应之间的关系。
研究了33例患者，平均随访期为9.4个月。平均56%的患者眼压下降30%或更多。约38%的患者在18个月时眼压持续降低至22毫米汞柱以下。并发症较少，包括短暂性低眼压和虹膜炎。
对于亚洲难治性青光眼患者或视力差（本研究定义为低于20/200）的疼痛性青光眼患者，采用玻璃球探头进行低能量设置的二极管激光接触式经巩膜睫状体光凝术相对有效且安全。
