改良二极管激光睫状体光凝术治疗中晚期青光眼

目的探讨经巩膜二极管激光睫状体光凝术(transscleral cyclophotocoagulation,TDLC)激光斑点数的选择治疗中晚期青光眼患者的疗效。方法连续收集2009年7月至2010年3月在我院接受TDLC治疗的不同类型中晚期青光眼患者27例27眼。根据青光眼患者术前眼压由低到高分为3组:在激光功率和持续时间(1500ms)不变的情况下,给予不同激光斑点数。随访术后1d、7d、14d、30d、60d、90d和180d的眼压,观察术后的近、中期效果。结果 27例27眼患者术前眼压为27～72(53.15±10.85)mmHg(1kPa=7.5mmHg),术后1d眼压为(28.78±7.40)mmHg,术后180d眼压为(18.37±2.02)mmHg。术后各阶段眼压平稳下降,并最终达到或接近正常眼压。术后任何同一时间点,90点组的术前术后眼压差都比70点组高,27例患者术后均未见视力下降发生。结论在激光功率和持续时间不变的情况下,按术前眼压给予不同的激光斑点数能更有效地控制术后眼压,不会增加并发症的发生和降低术后视力。

Improved transscleral cyclophotocoagulation by diode laser for advanced glaucoma

Objective To determine the efficacy of laser spots number choice in transscleral cyclophotocoagulation(TDLC) for advanced glaucoma patients.Methods A total of 27 eyes in 27 patients with advanced glaucoma were treated consecutively with TDLC from July 2009 to March 2010 in our hospital.According to the pretreatment intraocular pressure(IOP),the patients were divided into three groups from low to high IOP,with the same laser power and duration(1500 ms),and different number of laser spots were given in TDLC.The IOP at postoperative 1 day,7 days,14 days,30 days,60 days,90 days and 180 days were observed,and the postoperative near and medium efficacy were also observed.Results Mean preoperative IOP was(53.15±10.85)mmHg(1 kPa=7.5 mmHg,from 27 mmHg to 72 mmHg),at postoperative 1 day was(28.78±7.40)mmHg and at postoperative 180 days was(18.37±2.02)mmHg.IOP declined steadily after TDLC,and eventually reached the normal.The differences between preoperative and postoperative IOP at each time point in 90 spots group were higher than that in 70 spots group,the visual acuity in all patient did not decrease.Conclusion According to the preoperative IOP,giving different number of laser spots in TDLC under same laser power and duration is a safe and effective method to control IOP,and does not increase the incidence of complications or reduce the visual acuity.