超声乳化联合选择性小梁激光成形术在开角型青光眼中的作用

Effect of phacoemulsification with selective laser trabeculoplasty on primary open angle glaucoma

目的:比较选择性小梁激光成形术(SLT)和超声乳化联合选择性小梁激光成形术(Phaco+SLT)在药物控制良好的开角型青光眼(POAG)中的降眼压作用。方法:采用前瞻性临床病例对照研究,24例30眼药物控制眼压良好的开角型青光眼随机分为两组,其中Phaco+SLT组11例14眼;SLT组13例16眼。测量术后3,6,9mo的眼压及术后9mo的视力和抗青光眼用药数量。结果:两组术后平均眼压比术前眼压明显降低。Phaco+SLT组在术后6,9mo的平均眼压明显低于SLT组,两组眼压比较有统计学意义(P=0.001);两组术后抗青光眼用药数量比术前明显降低,两组间比较有统计学意义(P=0.03)。结论:Phaco+SLT和SLT能明显降低开角型青光眼患者眼压,Phaco+SLT降眼压作用明显优于SLT。

AIM： To compare the effect of primary open angle glaucoma （ POAG ） with well-controlled drugs on the intraocular pressure （ IOP ） using phacoemulsification combined selective laser trabeculoplasty （ phacoemulsification combined SLT） versus SLT alone. METHODS：By a prospective clinical case control study, 24 patients （30 eyes） with POAG were randomly divided into 2 groups：eleven patients （14 eyes） were treated with phacoemulsification combined SLT and 13 patients （ 16 eyes） were treated with SLT alone.IOP at 3, 6, 9mo, visual acuity and glaucoma medicines at 9mo were observed postoperatively. RESULTS： The mean IOP of both groups was significantly decreased after the surgery. IOP of phacoemulsification combined SLT had decreased markedly than SLT alone after 3, 6mo. There was statistical significance between the 2 groups （P=0.001）. The numbers of glaucoma drugs were markedly decreased postoperatively than preoperatively in both groups.Statistical significance were found between the 2 groups （P=0.03）. CONCLUSION： The study demonstrates that phacoemulsification with SLT and SLT can markedly reduce the IOP of POAG patients with good IOP control using drugs. The IOP - reducing effect of phacoemulsification combined SLT exceeds markedly than that of SLT alone.