摘要
目的观察选择性激光小梁成形术(selectlasertrabecularplasty,SLT)治疗各类型开角型青光眼(openangleglaucoma,OAG)降低眼内压的临床疗效和临床反应。方法对27例(52眼)多种类型开角型青光眼进行SLT治疗。所用设备为CoherentSelecta7000倍频Q-开关NdYAG双频激光仪。80个非重叠激光斑打击在颞侧180°范围小梁网,能量0.4～1.0mJ,激光斑400μm。术后观察眼内压和前房反应,时间为1d,1,6mo,1a。全部患者定期检查视力、裂隙灯、眼底镜、房角镜、视野(Octopus视野仪)、海德堡共焦激光断层扫描仪,(HRT-ⅡONH)和眼前节生物超声(UBM)检查。结果患者术前眼压平均(26.87±2.6)mmHg,不同时期的眼压大部分改善,术后1a为(20.21±3.4)mmHg,下降幅度为(6.66±2.8)mmHg,相当于下降24.78%,有3眼为高眼压症,没有明显降压效果出现。2眼为发育性青光眼,术后5d内降眼压效果明显,但10d左右眼压回升到接近术前水平转为手术治疗。部分病例仍需配合局部降眼压药。视力、C/D比、房角镜无明显改变。1a视野检查,9眼有改善。结论SLT治疗多种类型开角型青光眼安全有效,没有明显副作用和并发症,是治疗开角型青光眼的有效方法之一。
AIM: To evaluate the clinical efficacy on reduction of IOP using a Q-Switched 532nm neodymium (Nd): YAG laser, also known as 'selective laser trabeculoplasty' to lower intraocular pressure (IOP) on patients with open-angle glaucoma (OAG).· METHODS: Fifty-two eyes of 27 cases were treated with Coherent Selecta 7000 Frequency-doubled Q-Switched Nd: YAG Laser (532nm). Approximately 80 non-overlapping spots were placed over 180°of the trabecular meshwork (TM), with energy levels ranging from 0.4 to 1.0mJ per pulse, 400um laser spots. After surgery, test of IOP, visual acuity and inflammation in interior chamber were examined at 1d, 1mo, 6mo and 1a. All patients were examined with ophthalmoscope, gonioscopy, visual field, HRT-II ONH and UMB.· RESULTS: The mean preoperative IOP were reduced. After SLT, IOP were reduced by (6.66±2.8) mmHg in 1a, but there was no efficacy of reducing IOP in 3 eyes of ocular hypertension. Two eyes of developmental glaucoma IOP were clearly reduced in 5d. However, their IOP increased again at 10d. Some cases needed local reduced IOP eye drops. For all cases, visual acuity, c/d ratio, and gonioscopy had no obvious changes. Nine eyes' visual fields were improved at 10d.· CONCLUSION: The SLT appears to be safe and effective in lowering IOP without clear irreversible side effects or complications. Thus it is an effective method to lower IOP in patients with OAG.·
出处
《国际眼科杂志》
CAS
2004年第5期841-843,共3页
International Eye Science
