选择性激光小梁成形术治疗硅油填充眼继发性青光眼

Effect of selective laser trabeculoplasty in silicone oil related glaucoma

摘要:

目的：评估选择性激光小梁成形术(SLT)在硅油乳化相关继发性开角型青光眼(SO-OAG)中的降眼压作用。

方法：采用回顾性分析，选择硅油乳化取出后未达安全眼压的SO-OAG患者120例120眼，应用360° SLT治疗。评估患者治疗1wk， 1、3mo后平均眼压、用药种类和成功率。

结果：SLT治疗1wk， 1、3mo时的平均眼压分别为17.64±4.52、18.96±3.33、18.03±5.69mmHg，较治疗前眼压(25.02±5.93mmHg)明显降低(P=0.002、0.04、0.03)； 治疗1wk， 1、3mo后的平均用药种类分别为1.78±0.14、1.95±0.56、1.87±0.53种，较治疗前(3.11±0.62种)明显降低(P=0.006、0.04、0.02)； 治疗1wk后，显效82眼(68.3%)，有效24眼(20.0%)； 治疗1mo后，显效74眼(61.7%)，有效21眼(17.5%)； 治疗3mo后，显效77眼(64.2%)，有效15眼(12.5%)。

结论：SLT能有效降低最大耐受药物治疗不能控制眼压的SO-OAG患者的眼压。

Abstract:

AIM: To investigate the efficacy of selective laser trabeculoplasty(SLT)for lowering intraocular pressure(IOP)in patients with emulsified- silicone oil related secondary open angle glaucoma(SO-OAG).

METHODS: By a retrospective case study, consecutive case series of 120 eyes with sustained elevation of IOP after SO-OAG removal were treated by 360° SLT treatment. The mean IOP, mean number of glaucoma medications, and success rates at baseline 1wk, 1mo, 3mo were evaluated.

RESULTS: After the SLT treatment, the mean baseline IOP was significantly decreased from 25.02±5.93mmHg to 17.64±4.52mmHg at 1wk(P=0.002), 18.96±3.33mmHg at 1mo(P=0.04), and 18.03±5.69mmHg at 3mo(P=0.03). The mean number of glaucoma medications significantly decreased from 3.11±0.62 to 1.78±0.14 at 1wk(P=0.006), 1.95±0.56 at 1mo(P=0.04), and 1.87±0.53 at 3mo(P=0.02). The complete and qualified success rate were 68.3%(82 eyes)and(20.0%)(24 eyes)at 1wk, 61.7%(74 eyes)and 17.5%(21 eyes)at 1mo, and 64.2%(77 eyes)and 12.5%(15 eyes)at 3mo.

CONCLUSION: SLT may be effective for lowering IOP in patients with SO-OAG which was not controlled with maximum antiglaucomatous medical treatment.