激光小梁成形术前后对原发性开角型青光眼患者昼夜眼压变化影响

Intraocular pressure alterations around selective laser trabeculoplasty in primary open-angle glaucoma patients

目的评价选择性激光小梁成形术（SelectivelaserTrabeculoplastySLT）对原发性开角型青光眼（primaryopen—angleglaucoma，POAG）昼夜眼压的影响。方法POAG患者40例76只眼。倍频Q-开关532nmNdYAG激光，3ns单脉冲，光斑直径400μm，激光击射下方180。范围小梁组织，能量0．53～0．89mJ，点数60～100点。气动眼压计测量术前及术后12周昼夜眼压，两组数值比较采用配对t检验。结果术前平均眼压（21．6±2．87）mmHg（1mmHg-0．133KPa），术后平均眼压（18．7±1．36）mmHg，两组比较P〈0．05（t=7．69）；手术前后6am点术眼眼压降低最明显，为6．9mmHg。术前眼压高峰出现在6am，波谷最低在10pm，昼夜眼压波动6．4mmHg；术后眼压高峰移至12时，最低在22时，昼夜眼压波动3．2mmHg。结论SLT治疗原发性开角型青光眼安全、可靠，可有效降低POAG患者的平均眼内压，降低昼夜眼压波动。

Objective To evaluate the influence on intraocular pressure of primary open-angle glaucoma patients aider selective laser trabeculoplasty. Methods Forty cases （76 eyes） of POAG, multiple-frequency Q, 532nm Nd YAG 3ns single pulse laser （power 0.53-0.89mJ, 60-100 points, laser diameter 400μm） was performed to inferior 180° trabeculum tissues. The intraocular pressure pre-operation and 12 weeks post operation were detected, data was analyzed by T test. Results The average intraocular pressure was 21.6＋ 2.87 mmHg （lmmHg=0.133KPa） pre-operative and 18.7±1.36mmHg post operative, there was statistically significant difference （ t=7.69, P〈0.05 ） ; lOP decreased most obviously （6.9mmHg） at 6am. The peak IOP pre-operative appeared at 6am and the lowest lOP appeared at 10pm, the change of lOP was 6.4 mmHg; the peak lOP post-operative appeared at 12am and the lowest lOP appeared at 10pm, the change of IOP was 3.2 mmHg. Conclusions SLT is a safe operation to POAG, it can decrease the mean IOP and lOP wave motion day and night effectively in POAG patients.