选择性激光小梁成形术治疗原发性开角型青光眼

目的: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)观察。方法:原发性开角型青光眼80例160眼,蓝黄视野检查未见明显损害或轻度损害,眼压>30mmHg者20例40眼,眼压<30mmHg者60例120眼。使用倍频Q开关,波长532nm,Nd∶YAG激光,照射180°~360°小梁网,光斑400nm,脉宽3μs,能量设置0.3~1.0mJ。光斑点数50~80点,术后1d;1wk;1,3,6mo测眼压。结果:对于眼压在>30mmHg的POAG患者眼压控制不理想。眼压<30mmHg的POAG患者效果明显。结论:SLT的降眼压效果,虽然针对性较强,适宜患者人群窄,但给POAG的治疗提供了新思路和新希望。

Effect of selective laser trabeculoplasty on primary open angle glaucoma

·AIM:To observe the effect of selective laser trabeculoplasty(SLT)on primary open angle glaucoma(POAG).·METHODS:One hundred sixty eyes of 80 patients with POAG,of which intraocular pressure(IOP)in 40 eyes(20 patients)was over 30mmHg and 120 eyes(60 patients)below it,were observed with no obvious damage or mild damage by blue-on-yellow perimetry(BYP)examination.The patients were treated with the frequency-doubled Q-switched Nd∶YAG laser(532nm).Approximately 50-80 spots(facula 400nm)were placed over 180°-360°of the trabecular meshwork at energy levels ranging from 0.3 to 1.0 mJ per pulse(pulse width 3μs).IOP of 1 day,1 week,1,3 and 6 moths after surgery was detected.·RESULTS:SLT has visible effect on the patients with IOP below 30mmHg.However,IOP was not controlled ideally in the patients with IOP over 30mmHg.·CONCLUSION:Although SLT has the defects of narrow target and strong pertinency,it provides a new thought and hope for POAG treatment.·