选择性激光小梁成形术治疗高眼压症和不同病程原发性开角型青光眼的疗效观察

发布时间：2018-04-26 00:01

本文选题：选择性激光小梁成形术 + 原发性开角型青光眼　；参考：《眼科新进展》2017年09期

【摘要】：目的对比选择性激光小梁成形术(selective laser trabeculoplasty,SLT)治疗高眼压症(ocular hypertension,OHT)和早期、中期原发性开角型青光眼(primary open-angle glaucoma,POAG)的效果。方法根据病情将120例120眼患者分为OHT组(40例40眼)、早期POAG组(40例40眼)和中期POAG组(40例40眼),3组均使用532 nm倍频Q开关Nd:YAG激光器行SLT,激光单脉冲3 ns,光斑直径400 nm,初始能量为0.6 m J,以0.1 m J逐渐递减,至刚好出现香槟样气泡时为治疗能量,治疗范围为360°,术后1 d、1周、1个月、3个月及6个月随访,主要观察SLT治疗前后的眼压变化情况。结果治疗后1 d~6个月,OHT组、早期POAG组和中期POAG组术后各个时间点的眼压均较术前下降,差异均有统计学意义(均为P0.05)。各组内,SLT术后各时间点的眼压相比,差异亦均有统计学意义(均为P0.05)。OHT组、早期POAG组和中期POAG患者基线眼压分别为(25.95±1.80)mm Hg(1 k Pa=7.5 mm Hg)、(24.66±1.55)mm Hg和(25.62±2.67)mm Hg,差异有统计学意义(P0.05)。当剔除基线眼压的影响之后,术后1 d、1周、1个月、3个月、6个月,3组间的眼压相比差异均有统计学意义(均为P0.05)。在各组内,术后各时间点的眼压相比,差异亦均有统计学意义(均为P0.05)。与校正后的基线眼压相比,OHT组SLT术后眼压下降的幅度最大,其次是早期POAG组,中期POAG组下降的幅度最小。结论 SLT对于OHT和POAG患者具有良好的降眼压效果,SLT的治疗效果随POAG患者的病情严重程度逐次递减。
[Abstract]:Objective to compare the efficacy of selective laser trabeculoplasty (SLT) in the treatment of high ocular hypertension (OHT) and primary open angle glaucoma in early and middle stage (primary open angle glaucoma). Methods 120 patients (120 eyes) were divided into OHT group (40 cases, 40 eyes), early POAG group (40 eyes, 40 eyes) and middle stage POAG group (40 cases, 40 eyes) were treated with 532nm Q-switched Nd:YAG laser, laser single pulse 3ns, spot diameter 400. Nm, the initial energy is 0.6 MJ, and the initial energy decreases gradually with 0.1 MJ. Up to the time when champagne bubble appeared, the therapeutic energy was 360 掳. 1 week, 1 month, 3 months and 6 months after SLT were followed up. The changes of intraocular pressure were observed before and after SLT treatment. Results the IOP of OHT group, early POAG group and middle stage POAG group were significantly lower than those of preoperative group 1 ~ 6 months after treatment (P 0.05). There were significant differences in intraocular pressure (IOP) at different time points (all P0.05).OHT group, baseline IOP of early POAG group and middle stage POAG group were 24.66 卤1.55)mm Hg and 25.62 卤2.67)mm Hg, respectively), the difference was statistically significant (P 0.05). The intraocular pressure of early POAG group and middle stage POAG group were 24.66 卤1.55)mm Hg and 25.62 卤2.67)mm Hg, respectively. After the baseline IOP was excluded, there were significant differences in IOP between the three groups at 1 week, 1 month, 3 months and 6 months postoperatively (all P 0.05). In each group, there were significant differences in IOP at each time point after operation (P 0.05). Compared with baseline IOP after correction, IOP in OHT group was the largest after SLT, followed by early POAG group, and the decrease was the smallest in metaphase POAG group. Conclusion SLT has a good effect of lowering IOP in patients with OHT and POAG. The therapeutic effect of SLT decreases with the severity of POAG.
【作者单位】：广西壮族自治区人民医院眼科;广西医科大学;
【基金】：广西壮族自治区卫计委自筹经费课题(编号:Z2015349)~~
【分类号】：R779.6

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