选择性激光小梁成形术作为首次及辅助降眼压治疗的效果比较  

Outcomes comparation of selective laser trabeculoplasty between initial and adjunctive treatment

作　　者：朱敬 孙毅 田雪莲 郭娟[1] Zhu Jing;Sun Yi;Tian Xuelian;Guo Juan(Department of Ophthalmology,The Third People's Hospital of Chengdu,Affiliated Hospital of Southwest Jiao Tong University,Affiliated Chengdu Second Clinical College of Chongqing Medical University,Chengdu 610031,China)

机构地区：[1]成都市第三人民医院眼科,西南交通大学附属医学院,重庆医科大学第二附属医院,成都610031

出　　处：《眼科》2025年第2期102-107,共6页Ophthalmology in China

基　　金：四川省自然科学基金(2022NSFSC1400);四川省医学会青年基金(Q15045);成都市科技局基金(2022519);成都市第三人民医院内科研项目(CSY-YN-03-2024-034)。

摘　　要：目的研究分析中国人群中选择性激光小梁成形术(SLT)降眼压的疗效及其对用药数量的影响。设计回顾性病例系列。研究对象65例(77眼)行SLT治疗,其中原发性开角型青光眼(POAG组)40眼、高眼压症(OHT组)37眼。男性34例,女性31例,平均年龄(49.63±18.91)岁。方法SLT分别作为辅助治疗(n=40),或首诊治疗(n=37),分别于术前,术后1天,1周,1、3、6、12及36个月,对不同组间眼压、使用降眼压药物数量进行统计分析。主要指标眼压,降眼压药物数量。结果SLT作为辅助治疗者,治疗前POAG组眼压(22.63±2.15)mmHg,OHT组(23.48±1.83)mmHg;治疗后1天,1周,1、3个月较术前均明显下降(P均<0.05),四个时间点POAG组平均眼压(17.97±4.22)mmHg,OHT组平均眼压(19.61±3.19)mmHg;治疗后第6、12、36个月,患眼眼压与治疗前比较均无明显差异(P均>0.05),三个时间点POAG组平均眼压(21.15±1.79)mmHg,OHT组平均眼压(21.08±2.49)mmHg;治疗前,POAG组使用降眼药物(3.55±0.6)种,OHT组(2.94±0.73)种,治疗后36个月时平均降眼压用药数量均下降,分别为(2.49±0.62)种和(2.13±0.73)种(P均<0.05)。SLT作为首诊治疗者,治疗前POAG组眼压(25.77±2.62)mmHg,OHT组(27.26±2.12)mmHg,两组治疗后各个时间点眼压均比治疗前明显降低(P均<0.05),POAG组平均为(21.28±2.75)mmHg,OHT组平均为(21.9±2.21)mmHg。结论SLT对于开角型青光眼和高眼压症治疗效果相同。SLT作为辅助性治疗能够降低眼压,但有效维持时间为治疗后3个月,且其能够明显减少青光眼药物使用数量;SLT作为首选方法能降低眼压至36个月。Objective To study the effects of selective laser trabeculoplasty(SLT)on intraocular pressure(IOP)and number of glaucoma medications used in Chinese eyes.Design Retrospective case series.Participants 77 eyes of 65 patients with primary open-angle glaucoma(POAG,n=40)and ocular hypertension(OHT,n=37)were included.Among them,there were 34 males and 31 females with an average age of(49.63±18.91)years.Methods SLT were used as an adjuvant therapy(n=40)or as first-line treatment(n=37).Statistical analysis was performed on intraocular pressure(IOP)and the number of eye-drops used in different groups before surgery,1 day,1 week,1 month,3 months,6 months,12 months,and 36 months after surgery.Main Outcome Measures IOP and number of eye-drops used.Results As an adjuvant therapy,SLT was used to treat patients with POAG and OHT.The IOP before treatment was(22.63±2.15)mmHg in the POAG group and(23.48±1.83)mmHg in the OHT group;The IOP was significantly decreased at 1 day,1 week,1 month,and 3 months after treatment compared with that before surgery(all P<0.05).The average IOP was(17.97±4.22)mmHg in the POAG group and(19.61±3.19)mmHg in the OHT group;At 6,12,and 36 months after treatment,the average IOP was(21.15±1.79)mmHg in the POAG group and(21.08±2.49)mmHg in the OHT group,and there was no significant difference in IOP before and after treatment(all P>0.05).Before treatment,average number of eye-drops used was(3.55±0.60)in the POAG group,and(2.94±0.73)in OHT group.After treatment,the average number of eye-drops used decreased to(2.49±0.62)(POAG group)and(2.13±0.73)(OHT group)after 36 months,which were lower than the baseline(all P<0.05).SLT used as first-line treatment,the IOP was(25.77±2.62)mmHg in POAG group,and(27.26±2.12)mmHg in OHT group before treatment.After treatment,the IOP of both groups at each time point was significantly lower than that before treatment(both P<0.05),with an average of(21.28±2.75)mmHg for the POAG group and(21.9±2.21)mmHg for the OHT group.Conclusion SLT has the same therapeutic eff

关 键 词：选择性激光小梁成形术 原发性开角型青光眼 高眼压症 

分 类 号：R54[医药卫生—心血管疾病]