真空小梁成形术治疗原发性开角型青光眼及高眼压症的疗效和安全性研究

发布时间：2018-05-17 13:39

本文选题：开角型青光眼 + 高眼压症　；参考：《宁夏医科大学》2012年硕士论文

【摘要】：目的观察真空小梁成形术（PNT）治疗原发性开角型青光眼和高眼压症患者的疗效和安全性。方法宁夏眼科医院就诊的原发性开角型青光眼和高眼压症患者30眼(21例)，进行视力，屈光度，中央角膜厚度、眼压，，裂隙灯，前房角镜、眼底、视盘OCT及Humphrey自动视野计等全面眼科检查。所有患者签署知情同意书后行PNT1000型治疗仪（Ophthalmic International公司产）治疗，为巩固降眼压作用，一般在首次治疗后第七天重复治疗一次。首次治疗后1小时、1天、1周、2周、1个月、2个月、3个月复查，观察眼压、并发症及抗青光眼药物种类等情况。结果30眼患者治疗前眼压23.3±1.7mmHg，治疗后1天、1周、2周、1个月、2个月、3个月各时间点眼压分别为19.7±4.0mmHg、19.7±2.8mmHg、19.4±4.1mmHg、19.0±2.4mmHg、18.6±3.3mmHg、18.4±3.0mmHg，各时间点较治疗前基线眼压差异有统计学意义（P均0.001），25眼（83.3%）治疗后平均眼压下降幅度超过15%。使用抗青光眼药物（1到3种）的16眼，PNT治疗后3个月眼压与基线相比平均下降3.9mmHg (P0.05)，用药种类出现减少趋势。30眼在PNT治疗后仅出现结膜充血、水肿，结膜下出血，一过性视物模糊及异物感等轻微反应，三个月内最佳矫正视力、视网膜神经纤维层厚度及视神经未出现明显变化（p＞0.05）。结论本研究短期小样本证实PNT可以安全有效地降低原发性开角型青光眼和高眼压症患者的眼压，尤其对使用多种眼表降眼压药物、依存性差及无法耐受手术及激光的患者，PNT也可作为一种简单、无创的辅助降眼压方法。
[Abstract]:Objective to observe the efficacy and safety of vacuum trabeculoplasty (PNTs) in the treatment of primary open angle glaucoma and ocular hypertension. Methods 30 eyes of 21 patients with primary open angle glaucoma and high intraocular pressure were treated with visual acuity, diopter, central corneal thickness, intraocular pressure, slit lamp, anterior chamber angle lens, fundus. Optic disc OCT and Humphrey automatic visual field meter and other comprehensive ophthalmic examination. All patients were treated with PNT1000 Ophthalmic International after signing informed consent. In order to consolidate the effect of intraocular pressure reduction, they were treated repeatedly on the seventh day after the first treatment. The intraocular pressure, complications and kinds of antiglaucoma drugs were observed after 1 hour, 1 day, 1 week, 1 month, 2 months and 3 months after the first treatment. Results the IOP of 30 eyes before treatment was 23.3 卤1.7mmHg, and the IOP was 19.7 卤4.0mmHg 19.4 卤4.1mmHg 19.0 卤2.4mmHg 18.6 卤3.3mm Hg 18.6 卤3.3mmHg at each time point after treatment. There were significant differences in IOP between two weeks and two weeks, one month, two months, two months and three months after treatment. The drop in intraocular pressure was more than 15. The intraocular pressure (IOP) of 16 eyes treated with antiglaucoma drugs (1 to 3) decreased on average 3 months after treatment compared with baseline. There was a decreasing trend of drug use. 30 eyes showed conjunctival hyperemia, edema and subconjunctival hemorrhage after PNT treatment. There were no obvious changes in the thickness of retinal nerve fiber layer and optic nerve in three months after the slight reaction such as transient blurred vision and foreign body sensation (P > 0.05). Conclusion this study demonstrated that PNT can reduce intraocular pressure safely and effectively in patients with primary open angle glaucoma and high intraocular pressure, especially in patients with multiple ocular surface pressure lowering drugs. PNT can also be used as a simple, non-invasive assistant method for lowering IOP in patients with poor dependence and intolerable operation and laser.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R775

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