选择性激光小梁成形术对中晚期开角型青光眼的临床疗效评价

Effect of selective laser trabeculoplasty on intermediate and advanced primary open angle glaucoma

目的观察选择性激光小梁成形术治疗中、晚期开角型青光眼降低眼压的临床疗效。方法临床诊断为中、晚期开角型青光眼用药物或手术治疗后眼压仍偏高的患者23例35眼,使用科医人Selecta 7000倍频Q开关ND:YAG双频激光治疗仪行选择性激光小梁成形术(SLT)治疗,术后测量1h、1d、2周、1月、3月、6月眼压,并检查视力、前房和并发症,1m、3m、6m行HRT-Ⅱ、视野检查。结果治疗前后眼压比较,治疗后1h眼压高于治疗前眼压,平均升高1.9mmHg(0.25kPa);治疗后1d、2周、1月、3月及6月眼压均低于治疗前眼压,眼压降低平均值分别为8.5mmHg(1.13kPa)、5.2mmHg(0.69kPa)、5.0mmHg(0.67kPa)、4.7mmHg(0.63kPa)、4.5mmHg(0.60kPa)(P<0.000 1)。结论 SLT对开角型青光眼用药物或手术治疗后眼压仍偏高的中、晚期患者降低眼压有效,安全,可作为一种新的或补充治疗方法选择。

Objective To observe the effect of selective laser trabeculoplasty（SLT） on intermediate and advanced primary open angle glaucoma（POAG）.Methods SLT was performed for 23 patients（35 eyes） with uncontrolled intraocular pressure（IOP） after operation of intermediate and advanced POAG or topical drug treatment using a YAG laser therapy device.IOP,visual acuity,anterior chamber and complications were detected 1 hour,1 day,2 weeks,1 month,3 months and 6 months,respectively,after operation.Heidelberg retinal tomography-Ⅱ（HRT-Ⅱ） and visual field were checked 1 month,3 months and 6 months,respectively,after operation.Results The IOP was higher 1 hour after operation than before operation with a mean increase of 1.9mmHg（0.25kPa）.The IOP was lower 1 day,2 weeks,1 month,3 months and 6 months,respectively,post-operation than pre-operation with a mean decrease of 8.5mmHg（1.13kPa）,5.2mmHg（0.69kPa）,5.0mmHg（0.67kPa）,4.7mmHg（0.63kPa）,and 4.5mmHg（0.60kPa）,respectively（P0.000 1）.Conclusion SLT is an effective and safe procedure for intermediate and advanced POAG with uncontrolled IOP after operation or topical drug treatment,and can thus be used as a supplementary procedure.