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 Nd:YAG 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.%目的 对比选择性激光小梁成形术(selective laser trabeculoplasty,SLT)治疗高眼压症(ocular hypertension,OHT)和早期、中期原发性开角型青光眼(primary open-angle glaucoma,POAG)的效果.方法 根据病情将120例120眼患者分为OHT组(40例40眼)、早期POAG组(40例40眼)和中期POAG组(40例40眼),3组均使用532 nm倍频Q开关Nd:YAG激光器行SLT,激光单脉冲3 ns,光斑直径400 nm,初始能量为0.6mJ,以0.1mJ逐渐递减,至刚好出现香槟样气泡时为治疗能量,治疗范围为360°,术后1d、1周、1个月、3个月及6个月随访,主要观察SLT治疗前后的眼压变化情况.结果 治疗后1d～6个月,OHT组、早期POAG组和中期POAG组术后各个时间点的眼压均较术前下降,差异均有统计学意义(均为P＜0.05).各组内,SLT术后各时间点的眼压相比,差异亦均有统计学意义(均为P＜0.05).OHT组、早期POAG组和中期POAG患者基线眼压分别为(25.95±1.80) mmHg(1 kPa =7.5 mmHg)、(24.66±1.55) mmHg和(25.62±2.67) mmHg,差异有统计学意义(P＜0.05).当剔除基线眼压的影响之后,术后1d、1周、1个月、3个月、6个月,3组间的眼压相比差异均有统计学意义(均为P＜0.05).在各组内,术后各时间点的眼压相比,差异亦均有统计学意义(均为P＜0.05).与校正后的基线眼压相比,OHT组SLT术后眼压下降的幅度最大,其次是早期POAG组,中期POAG组下降的幅度最小.结论 SLT对于OHT和POAG患者具有良好的降眼压效果,SLT的治疗效果随POAG患者的病情严重程度逐次递减.
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