Clinical effects of selective laser trabeculoplasty in the treatment of ocular hypertension and different course of primary open angle glaucoma / 眼科新进展

ABSTRACT

Objective To compare the efficacy of selective laser trabeculoplasty (SLT) on the intraocular pressure (IOP) reduction in the treatment of ocular hypertension (OHT),early and moderate primary open angle glaucoma (POAG).Methods Non-randomized controlled study was conducted in 120 patients (120 eyes),who were divided into 3 groups according to the patients' condition,including OHT group with 40 eyes of 40 patients,early-stage POAG group (40 eyes of 40 patients) and medium-stage POAG group (40 eyes of 40 patients),aged rang from 16 to 79 years.SLT was performed on the 360° trabecular meshwork using 532 nm frequency-double Q-switched NdYAG laser (Selecta duet),with the pulse of 3 ns and spot diameter of 400 nm.The initial energy was 0.6 m J,which decreased at 0.1 mJ interval till champagne bubble appeared.The following-up was postoperative 1 day,1 week,1 month,3 months and 6 months,respectively,and changes in IOP before and after SLT was recorded and analyzed statistically.Resuits Postoperative IOP at different time points was significantly lower than that of preoperation in the three groups,with significant difference (all P ＜ 0.05).There was also significant difference in IOP of the each group at different time points after the operation (all P ＜ 0.05).The preoperative baseline IOP of OHT group,early-stage POAG group and medium-stage POAG group was (25.95 ± 1.80) nmHg (1 kPa =7.5 mmHg),(24.66 ± 1.55) mmHg and (25.62 ± 2.67) mmHg,respectively,approaching significant difference (P ＜0.05).After eliminating the influence of baseline IOP,intergroup differences of postoperative IOP at each time point in the three groups were statistically significant (all P ＜ 0.05),and intragroup differences were also significant (all P ＜ 0.05).When compared with corrected baseline IOP,the reduction of IOP was the largest in OHT group after SLT,followed by the early-stage POAG group,and the lowest was in the medium-stage POAG group.Conclusion SLT has a good effect on IOP reduction for OHT and POAG,and the treatment effect of SLT declines successively according to the severity of POAG.