曲伏前列素对大部分房角关闭的原发性闭角型青光眼的降眼压作用

IOP lowering effects of Travoprost in primary closure-angle glaucoma

目的在其他降眼压药物眼压控制不佳的原发性闭角型青光眼(房角部分开放但小于1/2)患者中评价曲伏前列素滴眼液的治疗效果。方法使用单种或多种降眼压药物后眼压控制不佳的原发性闭角型青光眼(房角有部分开放但小于1/2)患者26例,加用曲伏前列素滴眼液治疗。每晚点药1次,每次1滴。将连续点药后1、4、12周的眼压与基线眼压进行比较研究。根据房角情况分为A组(房角开放程度在1/4到1/2之间)和B组(房角部分开放但小于1/4),比较两组间的降眼压效果。同时观察血压、心率等全身及局部副作用及其患者的依从性。结果使用曲伏前列素滴眼液后眼压明显下降。连续点药1、4、12周眼压下降幅度分别为:A组(7.38±3.12)mm Hg、(8.92±5.21)mm Hg、(8.74±4.12)mm Hg(P<0.05);B组(8.25±5.22)mm Hg、(7.15±3.78)mmHg、(7.71±3.56)mm Hg(P=0.000)。两组间用药后相同时间点降压幅度比较,差异无统计学意义。用药前后,视力、视野、视乳头杯盘比、血压均无明显改变。不良反应发生率为21%,均为轻度,最主要的不良反应为结膜充血,但不妨碍继续用药。患者依从性好。结论曲伏前列素滴眼液对治疗其他降眼压药物眼压控制不佳、大部分房角关闭的原发性闭角型青光眼患者是有效和安全的。

Objective To evaluate the efficacy and safety of Travoprost to the patients with primary closure-angle glaucoma（ PCAG） whose intraocular pressure（ IOP） was not reduced to normal by other glaucoma drug. Methods 26 patients with PCAG whose intraocular pressure（ IOP） was not reduced to normal by other glaucoma drug were treated with Travoprost eye drops（ 0. 004%）. One drop was instilled to each eye in the evening. Intraocular pressure（ IOP） at weeks1,4 and 12 after sustained administration were compared with the baseline. Patients were divided into 2 groups： group A（ ciliary body can be seen between 90 degrees and 180 degrees of the angle of anterior chamber） and group B（ ciliary body can only be seen lower 90 degrees of the angle of anterior chamber）. Systematic and local adverse effects were also assessed. Results At weeks 1,4,12 after sustained administration,the reduction of IOP were 7. 38 ± 3. 12,8. 92 ± 5. 21,and 8. 74 ± 4. 12 mm Hg in group A,and 8. 25 ± 5. 22,7. 15 ± 3. 78,and 7. 71 ± 3. 56 mm Hg in group B. The difference between the 2 groups was not significant. No systematic and local adverse effects were observed,and the patients all had good compliance. Conclusions Travoprost reduced IOP significantly in patients with PCAG,and it is a safe topical medication.