曲伏前列素治疗抗青光眼术后眼压失控的原发性闭角型青光眼的短期疗效

The short-term lowering intraocular pressure efficacy of travoprost for residual primary angle closure glaucoma

目的观察曲伏前列素滴眼液对青光眼术后眼压失控的原发性闭角型青光眼的降眼压效果。设计前瞻性病例系列。研究对象2012年12月至2014年5月石家庄市第一眼科医院激光周边虹膜切开术后残余性青光眼患者5例5眼和小梁切除术后眼压失控的原发性闭角型青光眼患者26例30眼,房角镜下至少60°可见睫状体带。方法 0.004%曲伏前列素滴眼液每晚1次滴眼。用药前和用药后2、8和12周Goldmann压平眼压计测量眼压。主要指标眼压及副作用。结果用药前平均眼压(24.58±5.12)mm Hg,用药后2、8和12周时平均眼压分别为(18.48±3.12)mm Hg、(17.12±4.05)mm Hg和(17.05±3.98)mm Hg(P<0.001)。用药后12周未见全身及局部严重不良反应。结论短期的小样本观察表明,曲伏前列素滴眼液是治疗青光眼术后眼压失控但房角未完全关闭的原发性闭角型青光眼的一种有效降眼压药物。

Objective To observe the outcome of travoprost for uncontrolled intraocular pressure after antiglaucomatous surgery in patients with primary angle closure glaucoma （PACG）. Design Prospective case series. Participants The PACG patients with uncontrolled-intraocular pressure after laser periphery iridotomy （5 eyes of 5 cases） and trabeeulectomy （30 eyes of 26 cases） were consecutively recruited in First Hospital of Shijiazhuang City, whose 60°anterior chamber angle at least was kept in opening. Methods All patients were intervened with 0.004% travoprost once daily. The changes in intraoeular pressure were monitored with Goldmann applanation tonometer before and after management for 2 weeks, 8 weeks and 12 weeks. Mean Outcome Measures Intraocular pressure and side actions of the drug. Results The average intraocular pressure was 24.58±5.12 mmHg before intervention with travoprost. After treating for 2 weeks, 8 weeks and 12 weeks, the average intraocular pressure was 18.48±3.12 mmHg, 17.12±4.05 mmHg, and 17.05±3.98 mmHg, respectively （P〈0.001）. Systemic and local severe adverse reactions were not found in 12 weeks after administration. Conclusions This short-term observation of small samples showed that travoprost can effectively and safely reduce the uncontrollable intraocular pressure for patients with uncompletely anterior chamber angle closure of PACG after anti-glaueomatous operation.