RESUMEN
Background Transscleral diode laser cyclophotocoagulation (TDCP) was used to later stage of glaucoma in the past.However,the indications of TDCP are expanding gradually over time and there are more and more reports about its application in different stages and different types of glaucoma.Objective This study was to compare the clinical efficacy of TDCP and trabeculectomy for primary acute angle-closure glaucoma (PAACG) with persistent ocular hypertension.Methods Ninety-five PAACG patients with persistent ocular hypertension were retrospectively analyzed.The patients were divided into TDGP group (62 eyes of 56 cases) and trabeculectomy group (44 eyes of 39 cases) based on the difference of treating fashions.The clinical outcomes were compared between the two groups with the evaluating indexes of visual acuity,intraocular pressure (IOP) before and 1 week,3 months and the end of following-up as well as the number of drug used and the re-treatment.Results The demography was matched between the two groups (all at P＞0.05).The number of eyes with visual improvement was significantly different among the groups (x2 =30.927,P =0.002) in the TDCP group.Compared with before treatment,the number of visual improvement in 1 week after treatment was significantly raised (x2 =16.778,P =0.002).No significant differences were seen in the eye number of visual improvement in various timepoints after treatment (all at P＞0.008).Also,the eye number of visual improvement was significantly different among the different timepoints (x2 =44.345,P＜0.001),and statistically significant change was found between the preoperation and postoperative 1 week (x2 =23.725,P＜0.001).However,there were no significant differences in the eye number of visual improvement in various timepoints after operation each other (all at P＞0.008).The IOP was insignificantly altered among the groups at various timepoints (Fgroup =3.836,P =0.053),but the change was significantly different over time (Ftime =757.078,P＜0.001).The postoperative IOP was significantly higher than that of preoperation in both groups (all at P＜0.001).The proportion of eyes using lowering-IOP drugs was 48.4％ in the TDCP group,and that in the trabeculectomy group was 27.3％,showing a significant difference between them (x2 =4.796,P =0.029).The retherapy was performed in 20 eyes (32.3％) and 2 eyes (4.5％) in the TDCP group and the trabeculectomy group,respectively.Conclusions The short-term lowing-IOP effecacy of TDCP is similar to trabeculectomy,but the longterm lowing-IOP efficacy of TDCP is not good.Compared with the trabeculectomy,TDCP shows more simple operation,less time-consuming during the surgery and milder tissue damage,but the eyes continuing to use anti-glaucomatous drugs or re-therapy are increased.
RESUMEN
Objective To evaluate the clinical efficiency of diode laser transscleral cyclophotocoagulation(TSCPC) for the treatment of refractory glaucoma.Methods TSCPC were performed in 23 eyes of 23 patients with medically and surgically uncontrolled glaucoma. The laser was operated with a power of 2～3W,duration of 1.5～2s and laser spots(18) were evenly placed 270 around the limbus except temporal. Followed for 3～24 months (average:11 months) . Results The mean intraocular pressure before and after treatment in 23 eyes were 6.10kPa±2.34kPa and 2.55kPa±1.22kPa respectively,which was statistically significant (P<0.01). IOP below 2.80kPa was obtained in 20 eyes (86.9%). At the time of last visit,the post-operative visual acuity was partly improved besides NLP.Conclusion Diode laser transscleral cyclophotocoagulation is effective in treating refractory glaucoma. Its advantages are low ratio of ocular hypotension,no atrophy of eyeball,no pain, acceptability,reoperation and therapeuty in clinic and so on.
RESUMEN
Objective To investigate the prevalence of macula choroidal neovascularization(CNV) in high myopia patients and the associated risk factors.Methods Fifty-six outpatients(112 eyes) with high myopia were medically examined from Mar.2008 to Jun.2009.The inspection items,including A scan,B scan,diopter and optical coherence tomography(OCT),were carried out to check whether CNV existed and its growth fashion.The patients' basic status,main symptoms and the pathologic change in macula were recorded.Results The prevalence of CNV in the 56 outpatients(112 eyes) was 14.3%.Gender showed no correlation with CNV(r=-0.015,P=0.879),while age(r=0.629,P=0.000),diopter(r=0.725,P=0.000),axial length(r=0.236,P=0.013),posterior scleral staphyloma(r=0.344,P=0.000),atrophy of choroid and retina in posterior pole(r=0.421,P=0.000),lacquer crack(r=0.421,P=0.000) and Fuchs spot(r=0.519,P=0.000) were significantly correlated with the prevalence of CNV.Conclusions CNV may highly occurred in the patients with high myopia.Posterior scleral staphyloma,atrophy of choroid and retina in posterior pole,lacquer crack,Fuchs spot,age,axial length and diopter seem to be the risk factors for the occurence of CNV.