选择性激光小梁成形术的研究进展

Advances on selective laser trabeculoplasty

青光眼是全球第一大不可逆的致盲性眼病,通过药物、激光和手术降低眼压是治疗青光眼的基本方法。选择性激光小梁成形术(SLT)是应用倍频Q开关、波长532 nm的掺钕钇铝石榴石激光,选择性作用于色素性小梁组织达到降低眼压目的。近30年来,SLT在不引起小梁网凝固性损伤的情况下可以降低眼压,已经逐渐成为治疗以原发性开角型青光眼为主的各种类型青光眼的初始治疗或替代治疗方法之一。本文中笔者就SLT的历史沿革、降眼压机制、临床应用、初始治疗、重复治疗、治疗成功的预测因素、并发不良反应、成本效益及健康相关生活质量等方面进行综述。

Glaucoma is the leading cause of irreversible blindness in the whole world.The basic treatment methods for glaucoma are concentrated on the intraocular pressure reduction by medication,laser and surgery.Selective laser trabeculectomy(SLT)is performed by using a Q-switched,frequency-doubled Nd:YAG laser at 532 nm wave length,which selectively acts on pigmentary trabecular tissue to reduce intraocular pressure.Over the past three decades,it has been demonstrated that SLT has become a safe and effective option of the alternative or initial treatments for various types of glaucoma,mainly primary open-angle glaucoma,because of intraocular pressure reduction with absent or minimal structural damage to the trabecular meshwork.The history of SLT,mechanisms of action,clinical application,initial treatment,repeat treatment,predictive factors of treatment success,complications and adverse reactions,cost-effectiveness,and health-related quality of life were reviewed in this paper.