选择性激光小梁成形术治疗原发性开角型青光眼

目的评价选择性小梁激光成形术（SLT）治疗各类原发性开角性青光眼（POAG）的疗效观察。方法79例（93眼）根据种族的不同（小梁Seheie色素分级）、年龄及眼压情况分为3组，采用国通公司倍频Q-开关。532nmND：YAG激光器，单脉冲，时间为3ns，波长532nm，光斑直径400μm，脉冲能量设置0．4～1．6mJ。术前在盐酸奥布卡因表麻下放置前房角镜，瞄准功能小梁网，选择相应的脉冲能量、象限范围和激光点数进行治疗或重复治疗。术后随访眼压（1h、1d、1周、1个月、3个月、6个月、1年）、眼底及视野。结果3个组79例（93眼）术前1年平均眼压依次为（23．1±6．3）mmHg、（26．52±6．1）mmHg和（29．52±6．1）mmHg；术后1年眼压依次为（12．52±4．3）mmHg、（15．58±4．7）mmHg和（16．65±4．5）mmHg。术前与术后眼压相比有显著下降（P〈0．01）。3个组眼底C／D比，术前为0．50～0．70±0．15～0．13；术后为0．57～0．68±0．16～0．42。视力：术前0．85～0．57±0．32～0．29；术后0．91～0．58±0．30～0．27，两者比较其差异均无统计学意义。结论SLT对各类POAG均有显著降压作用。

Selective laser trabeculoplasty in the treatment for primary open-angle glaucoma

Objective To evaluate selective laser trabeculoplasty(SLT) in treating primary open angle glaucoma(POAG) and observation on the therapeutic effect. Methods 79 patients, 93 eyes were divided into 3 groups acording to the different races, medical history, age, IOP. The ELLEX Laser distributed by GT-Medical Company,with double frequency, 532 nm, Nd:YAG, single pulse, pulse width 3ns, spot size 400 μm, pulse energy 0.4-1. 6mJ was used. Pre-op: Oxybuprocaine HCI for topical anesthesia, a gonioscope, aiming at functional trabecular meshwork, selected different pulse energy, quadrant, different spots, and/or retreatment. Post-op: IOP follow-up at 1 hour, 1 day, 1 week, 1 month, 3 months,6 months.1 year, retina, visual field, visual acuity. Results comparison on pre-op and post-op IOP, the three groups of 79 patients and 93 eyes, pre-op average IOP was (23. 134±6.34)mmHg, (26.524±6.11)mmHg and (29.52 ±6. 13) mmHg, 1-year post-op IOP was ( 12. 52 ± 4. 27 ) mmHg, ( 15. 58 ± 4. 71 ) mmHg and (16. 65 ±4. 48)mmHg. Therefore, the pre-op and post-op IOP has significantly decreased, shows the statistics meaning. Retina C/D ratio and VA: 3grooups C/D ratio pre-op: 0. 40-0. 50 ±0. 14-0. 12, 0. 50-0.70 ±0.15-0.13 and 0.60-0. 80 ±0.24-0.22; 1-year post-op is 0. 30-0. 45 ±0. 32-0.14, 0.47-0. 68 ±0.68-0.27 and 0.57-0. 70±0.16-0.4. VA( visual acuity) : pre-op: 1.00-0. 85 ±0.33-0.21, 0. 85-0. 57±0.32-0.29 and 0.63-0.41 ±0.41-0.24; 1-year post-op: 1. 00-0. 90 ±0. 12-0. 21, 0. 91-0. 58 ±0. 30-0.27 and 0.74-0.50 ±0.45-0. 52, the difference shows statistics meaning (P<0. 01). 3 months post-op visual field; there was no significant decrease in 1-year post-op, 6 months post-op visual field; there were 7 patients who had different degrees damage in the Group 3. Conclusion With applying SPSS10.0 statistical software, and matching t test, SLT has significant IOP reduction effect to different kinds of POAG.