180°和360°选择性激光小梁成形术治疗原发性开角型青光眼的疗效比较  

Comparison of curative effect between 180 and 360 degrees of selective laser trabeculoplasty in treatment of primary open angle glaucoma

作　　者：罗远湘[1] 杨炜[1] 邱明磊[1] 张奕霞[1] 

机构地区：[1]石河子大学医学院第一附属医院眼科

出　　处：《国际眼科杂志》2013年第7期1379-1381,共3页International Eye Science

摘　　要：目的:评价并比较180°和360°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)的临床效果。方法:POAG患者60例60眼,分别采用532nm倍频Q-开关Nd:YAG激光治疗仪,以光斑400μm,脉冲时间3ns,能量0.3～1.2mJ行180°和360°SLT。观察患者术后6mo的眼压变化。结果:两组患者眼压在激光治疗后均有显著下降,180°组患者术前平均眼压为25.6±2.0mmHg(1kPa=7.5mmHg),术后1h;1d;1wk;1,3,6mo眼压分别为27.1±2.1,16.5±1.9,19.6±1.9,18.5±1.8,19.9±1.9,20.3±1.8mmHg。360°组患者术前平均眼压为25.4±2.1mmHg,术后对应时间点眼压分别为26.6±1.9,15.9±2.0,19.0±2.0,17.8±1.9,18.7±2.0,19.2±1.9mmHg。两组术后1d;1wk;1,3,6mo的眼压与术前相比明显下降,差异均有统计学意义(P<0.01)。术后两组各时间点眼压的平均下降幅度比较,360°组较180°组术后眼压的平均下降幅度更大,其中术后3mo和6mo差异具有统计学意义(P<0.05)。结论:360°SLT治疗POAG的疗效可能优于180°SLT。AIM： To evaluate and compare the clinical effect of 180 and 360 degrees of selective laser trabeculoplasty （SLT） in treatment of primary open angle glaucoma（POAG）. METHODS： Totally 60 cases（60 eyes） of POAG were treated by SLT with light spot diameter of 400μm, irradiation time of 3 nanosecond, and power of 0. 3- 1.2mJ. Patients were evaluated 1 hour, 1 day, 1 week, 1 month, 3 and 6 months after laser treatment. RESULTS： Intraocular pressure （IOP） decreased significantly in two groups after laser treatment. The mean preoperative lOP was （25.6±2.0） mmHg （1kPa = 7.5mmHg） in 180-degree SLT group, and （25.4±2.1） mmHg in 360-degree SLT group. The mean lOP at 1 hour, 1 day, 1 week, 1 months, 3 months and 6 months postoperatively were （27. 1± 2. 1 ） mmHg, （ 16. 5 ± 1. 9 ） mmHg, （19. 6±1. 9） mmHg, （18. 5±1. 8） mmHg, （19.9±1.9）mmHg, （20.3±1. 8）mmHg, respectively, in 180- degree SLT group, and were （26.6±1.9） mmHg, （15.9± 2.0）mmHg, （19.0±2.0）mmHg, （17. 8±1. 9） mmHg, （18.7± 2.0）mmHg, （19.2±1. 9） mmHg, respectively, in 360- degree SLT group. There were statistically significant decreases in lOP at 1 day, 1 week, 1 month, 3 months and 6 months postoperatively compared with preoperative IOPin the two groups （ P〈0.01 ）. To compare the effect of two groups, the 360-degree SLT group showed significantly lower post-treatment lOP at each follow-up point relative to 360- degree SLT group, and its IOP reduction rate stayed statistically higher than the 180-degree group at 3 months and 6 months postoperatively（P〈0.05）. CONCLUSION ： This study suggests that 360-degree SLT is more effective than 180-degree SLT in treatment of POAG.

关 键 词：选择性激光小梁成形术 青光眼 眼压 

分 类 号：R779.63[医药卫生—眼科]