真空小梁成形术治疗原发性开角型青光眼

目的初步观察真空小梁成形术(pneumatic trabeculoplasty,PNT)治疗原发性开角型青光眼的临床效果。方法收集我院2011年1月至11月原发性开角型青光眼患者14例(20眼),均接受PNT治疗,观察PNT治疗前后的视力变化,记录PNT治疗前1h及治疗后1h、1d、7d、14d、30d、45d、60d、90d、120d的眼压情况,观察治疗后1个月、2个月、3个月及4个月眼压得到控制和眼压显著下降的患者数量。随访4个月,比较术前和术后4个月视网膜神经纤维层厚度。结果 PNT治疗前视力为0.76±0.23,治疗后为0.73±0.21,差异无统计学意义(P=0.26)。治疗后各时间点眼压与治疗前比较均明显下降,差异均有统计学意义(均为P<0.05)。治疗后1个月、2个月、3个月及4个月分别有13眼(65%)、12眼(60%)、11眼(55%)和5眼(25%)在减少药物或停用药物的情况下眼压得到控制,分别有17眼(85%)、15眼(75%)、15眼(75%)和11眼(55%)眼压显著下降。PNT治疗前使用药物治疗的患者治疗后所用药物明显减少。治疗后4个月各象限视网膜神经纤维层厚度与术前相比,差异均无统计学意义(均为P>0.05)。结论 PNT治疗原发性开角型青光眼安全有效。

Primary clinical observation of pneumatic trabeculoplasty for primary open-angle glaucoma

Objective To observe the clinical efficacy of pneumatic trabeculoplasty(PNT) for primary open-angle glaucoma(POAG).Methods From January 2011 to November 2011,a total of 20 eyes(14 patients) with POAG were enrolled.All 20 eyes received PNT.The visual acuity before and after PNT was recorded,and the intraocular pressure(IOP) at 1 hour before PNT,1 hour,1 day,7 days,14 days,30 days,45 days,60 days,90 days and 120 days after PNT were also recorded.The number of patients whose IOP was control and obviously decreased at 1 month,2 months,3 months and 4 months were investigated.The follow-up time was 4 months,the thickness of retinal never fiber layer was compared before PNT and 4 months after PNT.Results The visual acuity before and after PNT were 0.76±0.23 and 0.73±0.21,there was no statistical difference(P=0.26).IOP at each time point after PNT were lower than that before PNT,there were statistical differences(all P<0.05).IOP at 1 month,2 months,3 months and 4 months after PNT were controlled in 13 eyes(65%),12 eyes(60%),11 eyes(55%) and 5 eyes(25%),obviously decreased in 17 eyes(85%),15 eyes(75%),15 eyes(75%) and 11 eyes(55%).Patients were less dependent on IOP drugs after PNT.There was no statistical difference in thickness of retinal nerve fiber layer at each quadrant before and after PNT(both P>0.05).Conclusion PNT for primary open-angle glaucoma is safe and effective.