拉坦前列素治疗残余性闭角型青光眼的临床研究

The clinical study of latanoprost in treating with residual angle-closure glaucoma

目的观察拉坦前列素用于外滤过或虹膜周切术后的残余性闭角型青光眼的降眼压效果。方法采用随机、单盲、平行对照试验,选取外滤过或虹膜周切术后的残余性闭角型青光眼患者(眼压≥21mmHg且≤35mmHg,前房角检查至少累计90度范围内看到部分睫状体带),拉坦前列素组每晚一次,噻吗心安对照组早、晚各用一次,共观察8周。分别记录用药前、用药后1周、2周、4周、8周9am以及用药前、用药后8周4pm的眼压值。结果拉坦前列素组入选25例(25只眼),噻吗心安组入选24例(24只眼),两组用药后眼压都明显下降,拉坦前列素组从用药前的(24.73±3.90)mmHg(1mmHg=0.133kPa)降至8周时的(16.08±3.86)mmHg,下降幅度为35.0%;噻吗心安组从(26.00±4.44)mmHg降至(17.53±3.97)mmHg,下降幅度为32.6%。不同时间点上午两组眼压没有显著差异,而用药后8周4pm拉坦前列素组的眼压(15.33±3.16)mmHg明显低于噻吗心安组(18.76±4.13)mmHg(t=-3.016,P<0.05)。结论拉坦前列素可有效降低外滤过或虹膜周切术后的残余性闭角型青光眼的眼压,其作用较噻吗心安更持久。

Objective To investigate the effect of latanoprost in the treatment of residual angle-closure glaucoma after out-filtrating surgery or iridectomy.Methods Using randominzed,mono blind,parallel group control study and choosing patients with residual angle-closure glaucoma after out-filtrating surgery or iridectomy(IOP≥21mmHg,≤35mmHg,ciliary body can be seen in at least 90 degree of the angle of anterior chamber),latanoprost was applied once a day in the experiment group and timalol twice a day in the control group for 8 weeks.Intraocular pressure(IOP)was measured at 9am and 4pm before treatment,on week 8 in the follow-up,and at 9am on week 1,week 2,week 4 in the follow-up.Results There are 25 patients in the experiment group and 24 patients in the control group.After treatment IOP was markedly decreased in both groups.The daily IOP(mean± standard deviation)in the experiment group decreased from(24.73±3.90)mmHg(1mmHg=0.133 kPa)before to(16.08±3.86)mmHg on week 8,and the extent was 35.0%;The reduction in the control group was from(26.00±4.44)mmHg to(17.53±3.97)mmHg,and the extent was 32.6%.There was no difference between the two groups at 9am in the follow-up,but the IOP of the latanoprost group at 4pm on week 8(15.33±3.16)mmHg was markedly lower than that of the timolol group(18.76±4.13)mmHg(t=-3.016,P<0.05).Conclusions It is demonstrated that latanoprost is effective in reducing IOP of residual angle-closure glaucoma after out-filtrating surgery or iridectomy,and its role is more lasting than timolol.