PNT治疗开角型青光眼及高眼压症的临床观察

Clinical observation of PNT in treatment of primary open angle glaucoma and ocular hypertension

目的:对比研究真空小梁成形术(pneumatic trabeculoplasty,PNT)与0.05g/L拉坦前列腺素滴眼液治疗开角型青光眼及高眼压症患者的临床效果。方法:选取我院就诊的开角型青光眼及高眼压症患者30例48眼,随机分为A,B两组,A组12例24眼行PNT治疗,B组18例24眼给予0.05g/L拉坦前列腺素滴眼液点眼,频次1次/睡前。记录两组治疗前后的视力、眼压、视野及视盘周围神经纤维层厚度变化,进行统计分析。结果:眼压:A组治疗后1～3mo平均眼压值较治疗前明显降低(P<0.01)。B组整个治疗过程平均眼压均较治疗前明显降低(P<0.01)。治疗后1～6mo眼压降低≥20%的眼数,A组分别占79%,62%,50%,25%,12%,0;B组分别为92%,83%,83%,79%,71%,62%,两组第3mo开始差异有统计学意义(P=0.014)。在治疗随访过程中,两组患者的视力、视野及视盘周围神经纤维层厚度均无明显变化(P>0.05)。不良反应:A组多为一过性结膜充血及结膜下出血,且均在1wk内吸收消失;B组有8眼治疗后持续结膜充血较明显,有5例8眼患者诉不同程度刺激症状。结论:真空小梁成形术和0.05g/L拉坦前列腺素滴眼液均能有效降低开角型青光眼及高眼压症患者眼压,但前者副作用更小,而后者降眼压效果持久。

AIM：Toevaluate the efficacy of pneumatic trabeculoplasty （PNT） compared with latanoprost 0.05g/L in primary open angle glaucoma （POAG） and ocular hypertension（OH）.METHODS：In a randomized clinical study, a total of 30 patients（48 eyes） with POAG and OH were divided into two groups randomly. 12 patients （24 eyes） of group A and 18 patients （24 eyes） of group B underwent PNT and latanoprost 0.05g/L, respectively. And vision, intraocular pressure（IOP）, vision field and retinal nerve fiber layer（RNFL） were evaluated.RESULTS：One to three months after treatment, the average IOP in group A degraded significantly（P0.01） , and the average IOP in B group degraded significantly （P0.01）. 1-6 months after treatment, the number of eyes with IOP reduction ≥20% in group A was 79%, 62%, 50%, 25%, 12%, 0 respectively, and that in group B was 92%, 83%, 83%, 79%, 71%, 62% respectively, there was statistically significant difference between two groups from the third month. There was no statistically significant difference in vision, IOP, vision field and RNFL during the entire follow-up duration. There were transient conjunctival congestion and subconjunctival hemorrhage in group A, but they were absorbed in a week; there were 8 eyes with significant and persistent conjunctival congestion in group B, and irritation of different degrees in 5 patients（8 eyes）.CONCLUSION：PNT and latanoprost eye drops can reduce the IOP of patients with POAG and OH, but there were less side effects in group A, and there was a persistent reducing IOP effect in B group.