选择性激光小梁成形术的疗效观察

Therapeutic effect of selective laser trabeculoplasty

目的观察选择性激光小梁成形术(SLT)降眼压的临床疗效。方法对青光眼患者30例37眼进行SLT。其中男性17例,女性13例,平均年龄(65±13)岁。有晶体眼20眼,假晶体眼17眼。病种有原发性开角型青光眼28眼,正常眼压青光眼6眼,囊膜性青光眼3眼,随访病程均超过3个月,平均8.6个月。Nd:YAG激光斑打击在下方180°范围的小梁网,激光点数约70～90点。结果平均眼压术前为(21±5)mm Hg,术后3个月为(16±5)mm Hg,术后6个月为(15±4)mm Hg。眼压下降率在20%以上的有20眼(54%),20%以下的17眼(46%)。无明显效果的6眼(16%)再次追加SLT,3眼(8%)行小梁切除术。SLT治疗前应用2种以下滴眼液点眼的病例比3种以上的病例可获得更好的疗效(P<0.05)。结论 SLT治疗青光眼安全且有降眼压的效果。眼压较高的青光眼患者在进行手术前可先考虑SLT治疗。

Objective To report the therapeutic effect of selective laser trabeculoplasty.Methods This retrospective study was made on 37 eyes of 30 patients.The series comprised 17 males and 13 females.The average age was（65±13） years.Twenty eyes were phakic and 17 were pseudophakic.Primary open-angle glaucoma was present in 28 eyes,normal-tension glaucoma in 6 eyes,and capsular glaucoma in 3 eyes.Cases were followed up for 3 months or longer,8.6 months on average.Nd：YAG laser was applied to inferior sector totaling 70 to 90 shots.Results Intraocular pressure（IOP） averaged（21±5）mm Hg before treatment,（16±5）mm Hg after 3 months,and（15±4）mm Hg after 6 months.IOP decreased by 20% or more in 20 eyes（54%） and less in 17 eyes（46%）.Out of these 16 eyes,6 eyes（16%） received the same treatment and 3 eyes（8%） received laser trabeculectomy.Eyes receiving 2 or less topical medications showed significantly greater reduction in IOP than the rest（P〈0.05）.Conclusion Selective laser trabeculoplasty is safe and effective in reducing IOP.