Geyer O
Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Israel.
Ophthalmology. 1998 Jun;105(6):983-7. doi: 10.1016/S0161-6420(98)96023-7.
The purpose of the study was to test the efficacy of the neodymium:YAG (Nd:YAG) laser for repairing filtering blebs.
The study design was a prospective study.
Five eyes of five patients with leaking blebs (group 1), five eyes of five patients with large irritating blebs (group 2), and four eyes of four patients with inadvertent filtering blebs in the surgical wound after cataract surgery (group 3) were studied.
The thermal mode of the Lasag Microrupter II Nd:YAG laser was used to treat the filtering blebs. The area of the bleb targeted for treatment was "painted" with methylene blue and then exposed to Nd:YAG laser treatment with an energy level of 2.5 to 3.75 J in a grid pattern. The aiming beam was focused on the conjunctiva, but the laser beam was offset according to the height of the bleb (offset of 0.9-1.5 mm, 4-5 on the Lasag) to selectively treat the internal surface of the bleb.
Symptomatology, intraocular pressure (IOP), and complications were measured.
After the laser treatment, all the leaks in group 1 were healed, all the patients in group 2 reported relief of their symptoms, and all blebs in group 3 shrank considerably. The IOP increased significantly (P < 0.001) after laser treatment in all three groups. This elevation appeared to diminish over time, with the major increase in IOP being recorded within the first month after the laser treatment. However, satisfactory IOP control was maintained in nearly all patients (13 to 14) who received none or one antiglaucoma medication. The visual acuity of one patient decreased significantly because of cataract formation. Complications included transient pressure rise (1 eye), bleb failure (1 eye), pupillary retraction toward the bleb (6 eyes), iatrogenic bleb leak (6 eyes), and cataract (1 eye).
The continuous wave Nd:YAG laser is an effective tool for repairing bleb-related problems while maintaining successful filtration.
本研究旨在测试钕：钇铝石榴石（Nd:YAG）激光修复滤过泡的疗效。
本研究设计为前瞻性研究。
研究了5例滤过泡渗漏患者的5只眼（第1组）、5例大的刺激性滤过泡患者的5只眼（第2组）和4例白内障手术后手术伤口处意外滤过泡患者的4只眼（第3组）。
使用Lasag Microrupter II Nd:YAG激光的热模式治疗滤过泡。用亚甲蓝“标记”目标治疗滤过泡区域，然后以网格模式用能量水平为2.5至3.75 J的Nd:YAG激光进行治疗。瞄准光束聚焦于结膜，但激光束根据滤过泡的高度进行偏移（偏移0.9 - 1.5 mm，Lasag上为4 - 5），以选择性地治疗滤过泡内表面。
测量症状、眼压（IOP）和并发症。
激光治疗后，第1组所有渗漏均愈合，第2组所有患者症状缓解，第3组所有滤过泡均明显缩小。三组激光治疗后眼压均显著升高（P < 0.001）。这种升高似乎随时间逐渐减轻，眼压的主要升高出现在激光治疗后的第一个月内。然而，几乎所有未使用或仅使用一种抗青光眼药物的患者（13至14例）眼压控制良好。1例患者因白内障形成视力显著下降。并发症包括短暂眼压升高（1只眼）、滤过泡失败（1只眼）、瞳孔向滤过泡回缩（6只眼）、医源性滤过泡渗漏（6只眼）和白内障（1只眼）。
连续波Nd:YAG激光是修复与滤过泡相关问题并维持成功滤过的有效工具。
