Comparison of long-term outcomes of selective laser trabeculoplasty versus argon laser trabeculoplasty in open-angle glaucoma
Comparison of long-term outcomes of selective laser trabeculoplasty versus argon laser trabeculoplasty in open-angle glaucoma
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DOI：
10.1016/j.ophtha.2004.04.030
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发表时间：
2004-10-01
期刊：
影响因子：
13.7
通讯作者：
Shin, DH
中科院分区：
文献类型：
--
作者：
Juzych, MS;Chopra, V;Shin, DH
目的：比较选择性激光小梁成形术（ALT）与氩激光小梁成形术（ALT）的长期成功率。设计：回顾性图表回顾。参与者：195例未控制的开角型青光眼（OAG）患者的195只眼，其中154只眼接受ALT，41只眼接受ALT，并随访最长5年。干预：采用倍频调Q钕钇铝石榴石激光（532 nm）治疗。在1800个小梁网上放置约50至55个非重叠点，能量水平范围为0.6至1.0 mJ/脉冲。ALT患者用氩蓝绿激光治疗，45至55个相邻的，不重叠的斑点超过1800小梁网在470至1150 mW的能量每pulse.Main结果测量：成功率被定义为标准I和标准II。标准I的成功定义为眼内压（IOP）降低3 mmHg或以上，且未使用其他药物、激光或青光眼手术。标准II的要求与标准I相同，除了成功需要IOP降低20%或更多。结果：平均随访时间为37.4 +/- 14.7个月，在ALT组的患者和33.6 +/- 17.0个月。ALT组和ALT组之间的长期成功率在任一标准下均无显著差异（Kaplan-Meier生存分析对数秩P = 0.20（标准I）和P = 0.12（标准II））。当比较有和没有以前的ALT的患者，有没有一个统计学上的显着差异，在治疗与ALT的患者的任何标准（对数秩P = 0.37的标准I和P = 0.39的标准II）。结论：在眼睛与原发性OAG正在接受最大限度的耐受药物治疗，SILT被认为是有效的ALT在降低眼压超过5年的时间。然而，长期数据显示，许多青光眼患者接受ALT和ALT治疗需要进一步的医疗或手术干预。在重复激光小梁成形术治疗中，小梁切除术是否比ALT具有更好的长期成功率仍不清楚。(C)2004年，美国眼科学会。
Purpose: To compare the long-term success rate of selective laser trabeculoplasty (SLT) versus argon laser trabeculoplasty (ALT).Design: Retrospective chart review.Participants: One hundred ninety-five eyes of 195 patients with uncontrolled open-angle glaucoma (OAG), of which 154 eyes underwent ALT and 41 eyes underwent SLT and were followed up for a maximum of 5 years.Intervention: The SLT patients were treated with the frequency-doubled q-switched neodymium:yytriumaluminum-garnet laser (532 nm). Approximately 50 to 55 nonoverlapping spots were placed over 1800 of the trabecular meshwork at energy levels ranging from 0.6 to 1.0 mJ per pulse. The ALT patients were treated with the argon blue-green laser with between 45 to 55 adjacent, nonoverlapping spots over 1800 of the trabecular meshwork at 470 to 1150 mW of energy per pulse.Main Outcome Measures: The success rates were defined by criterion I and criterion II. Success by criterion I was defined as a decrease in intraocular pressure (IOP) of 3 mmHg or more with no additional medications, laser, or glaucoma surgery. Criterion II had the same requirements as criterion I, except that a 20% or more IOP reduction was requiredfor success.Results: The mean follow-up time was 37.4 +/- 14.7 months for patients in the SLT group and 33.6 +/- 17.0 months for patients in the ALT group. The long-term success rate was not significantly different between the ALT and SLT groups by either criterion (Kaplan-Meier survival analysis log-rank P = 0.20 by criterion I and P = 0.12 by criterion II). When comparing patients with and without previous ALT, there was not a statistically significant difference in the patients treated with SLT by either criterion (log-rank P = 0.37 by criterion I and P = 0.39 by criterion II).Conclusions: In eyes with primary OAG that are receiving maximally tolerated medical therapy, SILT was found to be as effective as ALT in lowering IOP over a 5-year period. However, long-term data reveal that many of the glaucoma patients treated with SLT and ALT required further medical or surgical intervention. Whether SLT has better long-term success than ALT in repeat laser trabeculoplasty treatments remains unclear. (C) 2004 by the American Academy of Ophthalmology.