Yap-Veloso M I, Simmons R B, Echelman D A, Gonzales T K, Veira W J, Simmons R J
Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA.
J Glaucoma. 1998 Oct;7(5):319-28.
The effect of contact transscleral diode cyclophotocoagulation (TDC) on intraocular pressure (IOP) and its safety was determined in eyes with intractable glaucoma.
The charts of 41 consecutive patients (43 eyes) who underwent the laser procedure were reviewed. After surgery, data were collected from chart entries at I hour, 1 day, 4 to 6 weeks, 4 to 6 months, and at the final visit (6-24 months). Mean differences in IOP before and after treatment were compared using the paired Student t test. Associated complications also were assessed.
The mean +/- standard deviation follow-up period was 11.9+/-5.3 months (range, 6-24 months). One patient who died after 1 month of follow-up and another patient with neovascular glaucoma who underwent an anterior chamber washout 1 week after laser to treat an uncontrolled IOP spike were excluded from the study. Repeat treatment was done in 12 (28%) eyes. At each follow-up visit postoperatively, a significant reduction from preoperative IOP was obtained (mean reduction of 50% at the final visit). At the final visit, 64% of patients achieved an IOP of <22 mmHg and a reduction of > or =20%. An IOP spike occurred in three (7%) eyes. Long-term complications included loss of vision (> or =2 lines) in eight (22%) patients, corneal decompensation in one (2%), phthisis bulbi in one (2%), and corneal graft rejection in one (2%).
Although effective IOP reduction was demonstrated in eyes with intractable glaucoma after TDC, a significant proportion (26%) of eyes had severe long-term complications.
确定接触式经巩膜二极管睫状体光凝术（TDC）对难治性青光眼患者眼压（IOP）的影响及其安全性。
回顾了连续41例患者（43只眼）接受该激光手术的病历。术后，在1小时、1天、4至6周、4至6个月以及最后一次随访（6至24个月）时从病历记录中收集数据。使用配对t检验比较治疗前后眼压的平均差异。还评估了相关并发症。
平均随访时间为11.9±5.3个月（范围6至24个月）。一名随访1个月后死亡的患者以及另一名新生血管性青光眼患者在激光治疗后1周因眼压失控进行前房冲洗，这两名患者被排除在研究之外。12只眼（28%）进行了重复治疗。术后每次随访时，眼压均较术前显著降低（最后一次随访时平均降低50%）。在最后一次随访时，64%的患者眼压降至<22 mmHg且降低幅度≥20%。3只眼（7%）出现眼压峰值。长期并发症包括8名患者（22%）视力下降（≥2行）、1名患者（2%）角膜失代偿、1名患者（2%）眼球痨和1名患者（2%）角膜移植排斥反应。
尽管TDC术后难治性青光眼患者眼压显著降低，但相当比例（26%）的患者出现了严重的长期并发症。
