不同脉冲时间半导体激光经巩膜睫状体光凝治疗难治性青光眼临床研究

Transscleral diode laser yclophotocoagulation (TSCPC) with different pulse time for the late refractory glaucoma

目的观察采用不同脉冲时间810nm半导体激光进行经巩膜睫状体光凝术治疗晚期难治性青光眼的疗效及并发症,筛选有效的脉冲时间。方法本研究采用前瞻性研究方法。将晚期难治性青光眼患者39例(40只眼)随机分成两组,采用810nm半导体激光,分别应用长脉冲时间(4s)和传统标准脉冲时间(2s)行经巩膜睫状体光凝术,术后检测眼压、进行疼痛症状评估、观察并发症,筛选有效的脉冲时间,评价治疗效果。结果长脉冲时间组19例(20只眼),眼压由术前(57.16±11.68)mmHg降至(19.71±13.36)mmHg,显效率80%,术后疼痛、前房反应、出血较轻;传统标准脉冲时间组20例(20只眼),眼压由术前(55.39±10.93)mmHg降至(19.55±10.74)mmHg,显效率85%,术后疼痛、前房反应、出血较重。两组术后同样有效降低眼压,术后眼压没有显著差异(P(0.05),治疗效果无显著差异,长脉冲时间组比标准脉冲时间组疼痛及并发症更轻更少(P(0.05)。结论半导体激光经巩膜睫状体光凝术治疗难治性青光眼,采用长脉冲时间半导体激光,与传统标准脉冲时间相比,同样可以有效的降低眼压,而且并发症更少,更安全。

Objective To evaluate the therapeutic efficacy of contact transscleral diode laser cyclophotocoagulation with different pulse time setting on the late refractory glaucoma and screen the effective pulse time.Methods Perspective study. 40 eyes from 39 patients with refractory glaucoma underwent 810 nm diode laser cyclophotocoagulation with different pulse time. The patients were randomly divided into two groups including longer pulse time （4s） group and standard pulse time （2s） group. After 6-month follow up, the data, including the intraocular pressure （IOP） , the effective rate, and complications were recorded. Paired t test and χ2 test were performed.Results In longer pulse time（4s） group, the mean preoperative IOP is （57.16±11.68） mm Hg, the mean postoperative IOP is （19.71±13.36） mm Hg, and the effective rate was 80%. In standard pulse time （2s）group, the mean preoperative IOP is （55.39±10.93） mm Hg, the mean postoperative IOP is （19.55±10.74） mm Hg, and the effective rate was 85% （P﹥0.05）. The longer pulse time（4s） group had less and slighter complications（P﹤0.05）.Conclusion Compared with the standard pulse time （2s） group, longer pulse time（4s） diode laser cyclophotocoagulation on eyes of late refractory glaucoma has the same effective rate but less complications.