选择性激光小梁成形术治疗非动脉炎性前部缺血性视神经病变的疗效分析  

Selective laser trabeculoplasty for nonarteritic anterior ischemic optic neuropathy

作　　者：于爱萍[1] 肖云[1] 高晓唯[1] 

机构地区：[1]中国人民解放军第474医院全军眼科中心,新疆维吾尔自治区乌鲁木齐市830013

出　　处：《眼科新进展》2011年第11期1059-1061,共3页Recent Advances in Ophthalmology

摘　　要：目的回顾性分析利用选择性激光小梁成形术(selective laser traheculoplasty,SLT)降低眼压,进而增加眼动脉灌注治疗非动脉炎性前部缺血性视神经病变(nonarteritic anterior ischemic optic neuropathy,NAION)的临床效果。方法 70例(70眼)NAION患者,采用倍频Q-开关532nm Nd:YAG激光放射治疗。应用房角镜在360°房角范围激射小梁网,能量0.4～0.6mJ,光斑点数20～30点。术后分别测量1h、2h、1d、2d、3d、4d、5d、1周、2周、3周、1个月、3个月、6个月眼压,测量术后6个月视力,于6～12个月随访视野,对比术前及术后眼压、视力及视野情况。结果以NAION患者术前眼压较术后眼压降低≥3mm-Hg(1kPa=7.5mmHg)为有效,65眼有效率为92.86%,SLT术前平均眼压(23.6±3.8)mmHg,术后6个月的平均眼压(17.4±3.5)mmHg,除术后1h、2h外,余时间点眼压的降低差异均有统计学意义(均为P<0.001)。依据视力检查,治疗后视力提高3行以上为显著改善,以对照的70眼显著改善者56眼,占80.0%。视野有不同程度改善者66眼,无继续损害者3眼。结论通过SLT激光手术降低眼压、增加眼动脉灌注,达到了改善患者视神经缺血、从而保存视力及视野的目的。Objective To observe the effect of selective laser trabeculoplasty（SLT） in reducing the intraocular pressure（IOP）,then increasing the clinical therapeutic effect of ocular artery infusion on nonarteritic anterior ischemic optic neuropathy（NAION）.Methods Seventy patients（70 eyes） received 532 nm Nd：YAG laser with double frequency Q-switch,aiming at up and down 360 degree of trabecular meshwork by gonioscope with energy 0.4-0.6 mJ,20-30 shot spots.IOP at postoperative 1 hour,2 hours,1 day,2 days,3 days,4 days,5 days,1 week,2 weeks,3 weeks,1 month,3 months and 6 months were examined,the visual acuity at postoperative 6 months were measured,and the visual filed was followed up from 6 months to 12 months,the results were compared and analyzed.Results The effectiveness was set by reducing the IOP≥3 mmHg（1 kPa=7.5 mmHg）,the successful rate was 92.51%,the average pre-operative IOP was（23.6±3.8）mmHg,postoperative 6 months was（17.4±3.5）mmHg,there was no statistical difference in the decrease of IOP meaning except for postoperative 1 hour and 2 hours（all P〈0.001）.The visual acuity increasing 3 lines was set as marked improvement,the improving rate was 80.0%（56/70）.The visual fields were improved in 66 eyes,no impairment appeared in 3 eyes.Conclusion SLT can improve the ischemic optic nerve,increase the visual acuity and visual field by reducing IOP and increasing the ocular artery infusion.

关 键 词：选择性激光小梁成形术 缺血性视神经病变 眼压 

分 类 号：R777.2[医药卫生—眼科]