选择性激光小梁成形术治疗早期药物控制不佳的早发型房角后退性青光眼的临床研究  

Clinical efficacy of selective laser trabeculoplasty for early-onset angle recession glaucoma with poor early drug control

作　　者：廖伟 张玉明 黄菊 钟旭 LIAO Wei;ZHANG Yu-ming;HUANG Ju;ZHONG Xu(Department of Ophthalmology,Guilin People′s Hospital,Guilin 541002,China)

机构地区：[1]广西桂林市人民医院眼科,桂林市541002

出　　处：《广西医学》2018年第15期1691-1693,共3页Guangxi Medical Journal

摘　　要：目的探讨选择性激光小梁成形术(SLT)治疗早期药物控制不佳的早发型房角后退性青光眼的临床疗效。方法对26例(26眼)早期药物控制不佳的早发型房角后退性青光眼患者进行SLT治疗。记录患者术前、术后1 d、1周、1个月、3个月、6个月的眼压;于术前及术后6个月行光学相干断层成像检查视盘周围鼻侧、颞侧、上方、下方的视网膜神经纤维层(RNFC)厚度,行验光检查记录矫正视力;于术前及术后1个月、3个月、6个月检查视野平均缺损(MD);记录术后1周内并发症发生情况。结果患者术后1 d、1周、1个月、3个月、6个月眼压均低于术前(P<0.05);术前与术后6个月的视力及各象限RNFL厚度比较,差异均无统计学意义(均P>0.05);术前与术后1个月、3个月、6个月的视野MD比较,差异无统计学意义(P>0.05);术后1周无角膜灼伤、前房出血和严重前房反应发生。结论 SLT治疗早期药物控制不佳的早发型房角后退性青光眼具有良好的降眼压效果,术后反应轻,安全性好。Objective To explore the clinical efficacy of selective laser trabeculoplasty（SLT） for early-onset angle recession glaucoma with poor early drug control. Methods Twenty-six patients（26 eyes） with early-onset angle recession glaucoma with poor early drug control underwent SLT.Intraocular pressure was recorded before operation and one day,1 week,1 month,3 months and 6 months after operation.Before operation and 6 months after operation,optical coherence tomography was performed to determine the nasal,temporal, superior and inferior peripapillary retinal nerve fiber layer（RNFL） thickness,and the corrected visual acuity was recorded by optometry.The mean defect（MD） of visual field was examined before operation and 1 month,3 months and 6 months after operation,and the incidence of complications within 1 week after operation was recorded. Results The intraocular pressure was lower at 1 week,1 month,3 months and 6 months after operation compared to the postoperative（all P 〈0.05）.No significant differences were found between the preoperative and the postoperative 6-month visual acuity or RNFL thickness in any quadrants（ P 〉0.05）.The preoperative MD of visual field didn′t statistically differ from the postoperative 1-month,3-month or 6-month MD（ P 〉0.05）.No corneal burns,hyphema or severe anterior chamber reactions occurred within 1 week after operation. Conclusion SLT is safe for the treatment of early-onset recession glaucoma with poor early drug control,achieving less postoperative reaction and a favorable efficacy for reducing intraocular pressure.

关 键 词：早发型房角后退性青光眼 选择性激光小梁成形术 眼压 光学相干断层成像术 

分 类 号：R775[医药卫生—眼科]