选择性激光小梁成形术治疗开角型青光眼的研究进展

Research progress of selective laser trabeculoplasty for open-angle glaucoma

选择性激光小梁成形术（selective laser trabeculoplasty,SLT）采用倍频Q开关Nd：YAG激光,选择性作用于色素小梁网,而对邻近无色素小梁网不产生热损伤和凝固性破坏,目前对其作用机制的研究多集中于细胞因子的作用和后基因水平的改变.在SLT问世之初主要应用于原发性开角型青光眼的治疗,随着对其研究的深入,近年来SLT又被证明对其他类型的开角型青光眼也是安全有效的.在传统治疗参数的基础上,有学者认为低能量激光可以取得更好的疗效.目前已证实的影响SLT的降压效果的因素为基线眼压,基线眼压越高,效果越好.SLT术后常见的并发症包括一过性眼压升高、前房炎性反应以及结膜充血等.SLT的治疗能量与范围的选择、是否能替代传统的药物治疗而作为原发性开角型青光眼患者的初始治疗方法及其与药物配合治疗的最佳方案等问题仍需进一步研究探讨.

Selective laser trabeculoplasty （SLT） uses Q-switched 532 nm Neodymium：YAG laser to selectively target pigment trabecular meshwork cells,thus minimizing collateral thermal damage to surrounding tissue and the possibility of subsequent scarring.Now people pay more attention to the function of cytokines and alterations of postgenomic molecular level of SLT.SLT have been used to treat patients with primary open-angle glaucoma（OAG） in the beginning of its development.Recently it has been used to treat some other types of OAG.Now low-energy SLT are explored and proved effective.Now the confirmed effect factor of the efficacy of SLT is the baseline intraocular pressure（IOP）.The common complications of SLT include IOP peak,inflammation of anterior chamber and conjunctival injection.And several aspects,such as the selection of the practical energy and range for SLT treatment,if SLT could be selected as the first treatment for the OAG instead of the traditional medicine,and the best pattern to combine the SLT with medicine treatment,should be further explored in the future.