【摘要】 目的:评价并比较180°和360°选择性激光小梁成形术(selective laser trabeculoplasty,SLT)治疗原发性开角型青光眼(primary open angle glaucoma,POAG)的临床效果。方法:POAG患者60例60眼,分别采用532nm倍频Q-开关Nd:YAG激光治疗仪,以光斑400μm,脉冲时间3ns,能量0.3～1.2mJ行180°和360°SLT。观察患者术后6mo的眼压变化。结果:两组患者眼压在激光治疗后均有显著下降,180°组患者术前平均眼压为25.6±2.0mmHg(1kPa=7.5mmHg),术后1h;1d;1wk;1,3,6mo眼压分别为27.1±2.1,16.5±1.9,19.6±1.9,18.5±1.8,19.9±1.9,20.3±1.8mmHg。360°组患者术前平均眼压为25.4±2.1mmHg,术后对应时间点眼压分别为26.6±1.9,15.9±2.0,19.0±2.0,17.8±1.9,18.7±2.0,19.2±1.9mmHg。两组术后1d;1wk;1,3,6mo的眼压与术前相比明显下降,差异均有统计学意义(P<0.01)。术后两组各时间点眼压的平均下降幅度比较,360°组较180°组术后眼压的平均下降幅度更大,其中术后3mo和6mo差异具有统计学意义(P<0.05)。结论:360°SLT治疗POAG的疗效可能优于180°SLT。更多还原

【Abstract】 AIM: To evaluate and compare the clinical effect of 180 and 360 degrees of selective laser trabeculoplasty (SLT) in treatment of primary open angle glaucoma(POAG). METHODS: Totally 60 cases(60 eyes) of POAG were treated by SLT with light spot diameter of 400μm, irradiation time of 3 nanosecond, and power of 0.3-1.2mJ. Patients were evaluated 1 hour, 1 day, 1 week, 1 month, 3 and 6 months after laser treatment. RESULTS: Intraocular pressure (IOP) decreased significantly in two groups after laser treatment. The mean preoperative IOP was (25.6±2.0)mmHg (1kPa=7.5mmHg) in 180-degree SLT group, and (25.4±2.1)mmHg in 360-degree SLT group. The mean IOP at 1 hour, 1 day, 1 week, 1 months, 3 months and 6 months postoperatively were (27.1±2.1)mmHg, (16.5±1.9)mmHg, (19.6±1.9)mmHg, (18.5±1.8)mmHg, (19.9±1.9)mmHg, (20.3±1.8)mmHg, respectively, in 180-degree SLT group, and were (26.6±1.9)mmHg, (15.9±2.0)mmHg, (19.0±2.0)mmHg, (17.8±1.9)mmHg, (18.7±2.0)mmHg, (19.2±1.9)mmHg, respectively, in 360-degree SLT group. There were statistically significant decreases in IOP at 1 day, 1 week, 1 month, 3 months and 6 months postoperatively compared with preoperative IOP in the two groups (P<0.01). To compare the effect of two groups, the 360-degree SLT group showed significantly lower post-treatment IOP at each follow-up point relative to 360-degree SLT group, and its IOP reduction rate stayed statistically higher than the 180-degree group at 3 months and 6 months postoperatively(P<0.05). CONCLUSION: This study suggests that 360-degree SLT is more effective than 180-degree SLT in treatment of POAG.更多还原