真空小梁成形术治疗原发性开角型青光眼及高眼压症疗效观察

Efficacy of pneumatic trabeculoplasty in treating primary open-angle glaucoma and ocular hypertension

目的:观察真空小梁成形术(PNT)治疗原发性开角型青光眼(POAG)及高眼压症的临床疗效。方法:前瞻性病例设计。研究对象为2010年5月至2011年9月来我院就诊的POAG及高眼压症患者共58例(105眼)。入选患者治疗前进行眼科常规检查、眼压(Goldman眼压计)、房角镜、视野检查。患者单眼或双眼进行PNT1000型治疗仪(Ophthalmic International公司生产)治疗。观察首次治疗后1h、1d、1周、2周、1个月、3个月眼压、视力、眼局部应用降眼压药物种类。首次治疗后1周重复治疗1次。结果:58例(105眼)患者治疗前眼压为(23.7±4.2)mmHg、视力(LogMAR)为0.21±0.12、眼局部平均应用降眼压药物种类(2.23±0.72)种。治疗后1h、1d、1周、2周、1个月、3个月各时间点眼压分别为(23.0±3.6)、(19.8±5.1)、(18.2±4.0)、(19.0±5.1)、(19.3±3.8)、(19.9±3.8)mmHg;眼压下降幅度分别为0.70、3.90、5.50、4.70、4.40、3.80mmHg,除治疗后1h外,其余各时间点较治疗前眼压差异有统计学意义(P<0.001)。治疗后1d、1周视力为0.08±0.06、0.09±0.05;较治疗前视力差异有统计学意义(P<0.001);治疗后眼局部平均应用降眼压药物种类为(1.32±0.68)种,与治疗前比较差异有统计学意义(P<0.001)。结论:PNT术可有效地降低POAG和高眼压症患者的眼压、减少眼局部平均应用降眼压药物种类,使视力短暂改善。

Objective To study the efficacy of pneumatic trabeculoplasty （PNT） in treating patients with primary open-angl glaucoma and ocular hypertension. Methods There were 58 patients （105 eyes） with primary open-angle glaucoma or ocular hypertension in Beijing Shijitan hospital from May, 2010 to September, 2011. All subjects underwent ophthalmologic slit lamp microscope, gonioscopy, humphrey visual field examinations and intraocular pressure （IOP） measurement using applanation tonometre. One or two eyes of each one were treated with PNT Model 1000 （Ophthalmic International Inc.） at day 0 and 7. IOP and visual acuity measurement were repeated at 1 hour, 1 day, 1 week, 2 week, 1 month and 3 month after PNT therapy. The average number of eye drops for glaucoma was studied at 3 month after PNT therapy. Results Before treatment, the average IOP was （23.7 ± 4.2） mmHg, the average number of eye drops for glaucoma was 2.23 ± 0.72 and the visual acuity was 0.21 ± 0.12 （LogMAR）. The IOP of 1 hour, 1 day, 1 week, 2 week, 1 month and 3 month after PNT therapy were （23.0 ± 3.6）, （19.8 ± 5.1）, （18.2± 4.0）, （19.0 ± 5.1）, （19.3 ± 3.8）, （19.9 ± 3.8 ）mmHg, respectively. The IOPs of the follow-ups at each time point were 0.70, 3.90, 5.50, 4.70, 4.40, 3.80 mmHg, respectively. The IOPs at each time point except for 1 hour after treatment significantly decreased （P 〈 0.001 ） comparing to that before treatment. After 1-day and 1-week treatment, the average visual acuities were 0.08 ± 0.06 and 0.09 ± 0.05, respectively, showing a significant increase （P 〈 0.001 ） comparing to that before treatment. The average number of eye drops for glaucoma of 3 months after PNT therapy was 1.32 ± 0.68, the decrease of the average number of eye drops has a statistical significance （P 〈 0.001）. Conclusion The PNT therapy significantly depresses IOP and reduces the average number of eye drops for glaucoma and increases the visual acuity in a short time.