选择性激光小梁成形术治疗原发性青光眼的疗效

目的 评价选择性激光小梁成形术(selective laser trabeculoplasty,SLT)治疗原发性开角型青光眼(primary open-angle glaucoma,POAG)和原发性慢性闭角型青光眼(chronic primary angle-closure glaucoma,CPACG)的疗效及安全性.方法 收集我院眼科2007年1月至2008年1月就诊的原发性青光眼患者34例61眼,其中POAG组患者18例34眼,CPACG组患者16例27眼,2组均应用SLT治疗.观察患者术后1 h、1 d、1周、1个月、3个月、6个月的眼压以及术后6个月视力、视野、房角及角膜内皮细胞数等变化.结果 2组患者眼压在激光治疗后均有显著下降,POAG组患者术前平均眼压为(25.2±2.2)mmHg(1 kPa=7.5 mmHg),术后1 h、1 d、1周、1个月、3个月、6个月眼压分别为(28.9±1.3)mmHg、(17.0±1.9)mmHg、(19.9±1.7)mmHg、(20.1±1.8)mmHg、(18.2±2.1)mmHg、(18.0±2.1)mmHg.CPACG组患者术前平均眼压为(24.9±2.1)mmHg,术后对应时间点眼压分别为(29.3±1.6)mmHg、(16.9±2.0)mmHg、(20.3±1.8)mmHg、(19.3±1.9)mmHg、(20.1±2.0)mmHg、(18.9±2.2)mmHg.2组术后1 d、1周、1个月、3个月、6个月的眼压与术前相比明显下降,差异均有统计学意义(P均<0.05).术后1 d眼压下降最明显,术后一过性眼压升高为最常见的并发症.术后6个月2组患者随访视力、前房角、视野、角膜内皮细胞计数与术前比较均无明显变化.结论 SLT可以安全有效地降低POAG和房角大部分开放的CPACG患者的眼压.

Curative effects of selective laser trabeculoplasty for primary glaucoma

Objective To evaluate the efficacy and safety of selective laser trabeculoplasty(SLT) in the treatment of primary open-angle glaucoma(POAG) and chronic primary angle-closure glaucoma(CPACG). Methods SLT was operated in randomly selected 34 primary glaucoma patients (61 eyes), which included 18 POAG patients (34 eyes) and 16 CPACG patients (27 eyes), The changes of visual acnity,visual field,angle and corneal endothelial cell numbers were observed at 6 months postoperatively. IOP was measured at 1 hour,1 day,1 week,3 months and 6 months postoperatively,respectively, Results IOP decreased significantly in two groups after laser treatment. The mean preoperative IOP was (25.2±2.2) mmHg (1 kPa = 7.5 mmHg) in POAG group, and (24.9±2.1) mmHg in CPACG group. The mean IOP at 1 hour, 1 day, 1 week, 3 months and 6 months postoperatively were (28.9±1.3) mmHg, (17.0±1.9) mmHg, (19.9±1.7)mmHg,(20.1±1.8)mmHg, (18.2±2.1)mmHg and (18.0±2.1) mmHg, respectively ,in POAG group ,and were (29.3±1.6) mmHg (16.9±2.0) mmHg, (20.3±1.8) mmHg, (19.3±1.9) mmHg, (20.1±2.0) mmHg, (18.9±2.2) mmHg,respectively, in CPACG group. There were statistically significant decreases in IOP at 1 hour,1 day,1 week,3 months and 6 months postoperatively compared with preoperative IOP in the two groups(all P < 0.05). IOP decreased obviously at 1 day postoperatively. Transient high IOP was the most common complication. No significant differences was found about visual acuity,visual field, angle and corneal endothelial cell numbers between preand post-operation. Conclusion SLT is a safe and effective method for reducing IOP in POAG patients and CPACG patients with most opened angle.