选择性激光小梁成形术治疗原发性开角型青光眼的临床效果.docVIP

精品论文 参考文献 选择性激光小梁成形术治疗原发性开角型青光眼的临床效果 于浩 付晓娜 迟明美（山东省昌邑市人民医院　261300） 【中图分类号】R775 【文献标识码】A【文章编号】1672-5085（2013）16-0109-02 【摘要】 目的 探讨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的安全性和有效性。 方法 对24例30眼原发性开角型青光眼患者，8例10眼原发性开角型青光眼氩激光小梁成形术（argon laser trabeculoplasty，ALT）失败患者，采用倍频Q-开关532nmNd：YAG激光治疗。所有患者上方或下方房角180度范围内进行治疗，能量0.50～1.50mJ，点数80～100点。测量术后1h眼压，术后1d；1周；1月、3月、6月；1年随访，对比术前术后眼压、最佳矫正视力、视野及杯盘比变化。结果 患者术前眼压（24.35plusmn;6.12）mmHg，术后1h为（18.12plusmn;5.23）mmHg，1d为（15.62plusmn;3.61）mmHg，1周为（18.14plusmn;2.05）mmHg，1月为（16.58plusmn;3.22）mmHg，3月为（18.26plusmn;2.52）mmHg，6月为（17.02plusmn;2.31）mmHg，1年为（18.03plusmn;3.41）mmHg；术前患者杯盘比为 0.58plusmn;0.20，术后1年为0.57plusmn;0.30；术前视力0.81plusmn;0.30，术后1年视力为0.83plusmn;0.41；视野术前术后无变化。结论 选择性激光小梁成形术可以有效地降低原发性开角型青光眼及原发性开角型青光眼氩激光小梁成形术失败患者的眼内压。 【关键词】 选择性激光小梁成形术；原发性开角型青光眼；氩激光小梁成形术；眼内压 Clinical effection of selective laser trabeculoplasy on primary open glaucoma 【Abstract】Objective To evaluate the safety and efficiency of selective laser trabeculoplasty(SLT) on primary open angle glaucoma(POAG). Methods A total of 30 eyes of 24 patients with POAG,10 eyes of 8 POAG patients with failure after argon laser trabeculoplasty (ALT) therapy,and they were treated with a frequency-doubled, Q-switched Nd:YAG laser(532nm).A total of approximately 80～100 nonoverlaping spots were placed over 180deg;of the gonioscope nasal or temporal side at the energy levels ranging from 0.50-1.50mJ/pulse.Every patient was asked for follow-up at 1h,1d,1w,1m,3m,6m,and 1y after treatment. IOP,visual acuity,C/D and visual field were examined each time. Results The pretreatment IOP was (24.35plusmn;6.12)mmHg.At the end of first 1h,1d,1w,1m,3m,6m,1y of the follow-up,the IOP was (18.12plusmn;5.23)mmHg,(15.62plusmn;3.61)mmHg,(18.14plusmn;2.05)mmHg,(16.58plusmn;3.22)mmHg,(18.26plusmn;2.52)m-mHg,(17.02plusmn;2.31)mmHg,(18.03plusmn;3.41)mmHg respectively.The pretreatment cup/disc ratio was 0.58plusmn;0.20,at the end of 1yof the follow-up,the C/D ratio was0.57plusmn;0.30;the p