选择性激光小梁成形术治疗原发性开角型青光眼的临床观察

Clinical observation of selective laser trabeculoplasty on primary open angle glaucoma

目的:评价选择性激光小梁成形术(selective laser trabecu-loplasty,SLT)治疗原发性开角型青光眼的疗效和安全性及对不同条件原发性开角型青光眼治疗效果的差异。方法:原发性开角型青光眼46例46眼,分为A组(曾行小梁切除手术)21眼,B组(单纯药物治疗)14眼,C组(诊断未经治疗)11眼,经SLT治疗,随诊6mo,观察眼压、视力、视野等改变。结果:总体平均眼压在术后1d;1wk;1,3和6mo分别为(16.9±3.2),(18.7±3.3),(18.9±3.3),(19.8±3.2),(20.0±3.4)mmHg,均比术前眼压下降,具有显著性统计学差异,同一时间3组间比较无差异,术后反应均为一过性,1～3d内消失。结论:SLT治疗不同条件的原发性开角型青光眼均安全有效,长期疗效及重复治疗有待进一步观察。

AIM： To evaluate the efficiency and safety of selective laser trabeculoplasty （SLT） on primary open angle glaucoma （POAG） and compare the effect under different condition： POAG with previous trabeculoplasty , POAG with medical therapy and POAG without therapy. METHODS： 46 eyes of 46 patients with uncontrolled POAG （group A with previous trabeculectomy, group B with medical therapy and group C without therapy）were treated with a frequency-doubled, Q-switched Nd： YAG laser, intraocular pressure （lOP） was measured 1 hour, 1 day,1 week and 1,3,6 months after treatment. RESULTS： The average lOP was（16.9 ± 3.2）, （18.7± 3.3） ,（18.9±3.3） ,（19.8 ±3.2）,（20.0 ±3.4）mmHg at 1 day,1 week and 1,3, 6 months after SLT, respectively. There was significant lOP decrease after SLT and no difference among group A, B and C. CONCLUSlON：SLT is an effective and safe method to lower IOP of POAG no matter whether the patient had previous trabeculoplasty , medical therapy or without therapy.