- 期刊
- OpenAccess
接觸式二極體雷射經鞏膜睫狀體光凝固術在青光眼的初步經驗
Initial Experience of Contact Diode Laser Transscleral Cyclophotocoagulation in Glaucoma Patients
摘要
最近國外使用接觸式二極體雷射經鞏膜睫狀體光凝固術治療難癒性青光眼顯示良好的療效。本報告為以較低總能量初步對國人之使用報告。本研究應用G-Probe對18例20眼難癒性青光眼實施接觸式二極體雷射經鞏膜睫狀體光凝固術治療的結果。瞄準部位距輪部1.0到1.2mm之結膜部，每一眼接受的燒灼點數為9到12點，範圍為270°。雷射光波長810nm，使用功率1.5到2watt，燒灼時間為2秒。術後追蹤1到6個月，術後1個月眼壓較術前下降12.2±12.6mmHg(P=0.002)，術後3及6個月眼壓下降已不具統計上的意義。術後1、3及6個月眼壓較術前降低20%或超過20%的比率分別為61%、45%及11%。術後並無明顯的併發症。我們刻意減少燒灼點數為9到12點，有別於國外的16到18點，治療時的起始功率從1.5watt開始，也較國外為低，結果僅在術後1個月呈現有意義的降壓效果。本篇雖為初步研究結果，仍顯示接觸式二極體雷射經鞏膜睫狀體光凝固術在青光眼的治療上有其價值。向經驗顯示，初步低能量之照射對國人並無特別明顯的副作用，欲維持更長久之降壓效果，將來應考慮增加燒灼點以及功率，而長期的效果及併發症也需要更長期的觀察才能了解。
關鍵字
無資料並列摘要
Purpose: Recently, an effective contact diode laser system with less complication for transscleral cyclophotocoagulation (TSCPC) has been developed for refractory glaucoma. Our report will introduce our experience on this new procedure. Methods: We treated glaucoma patients refractory to medical, laser and surgical therapies with the IRIS Medical Oculight SLx Diode Laser System and the IRIS G-Probe. Each eye received 9 to 12 laser applications evenly spaced over 270° centered 1.0 to 1.2 mm behind the surgical limbus. We selected powers of 1.5, 1.75, 2 watts and used a duration of 2.0 seconds. Results were analyzed using paired t-test. Results: Total 20 eyses of 18 patients (12 males, 6 females, age 47.4±20.4 years old) were treated. The length of follow-up in this study ranged from 1 month to 6 months. IOP reduction was statistically significant within 1 month. No major complication and in particular, no conjunctival lesions were found. Conclusions: According to the initial experience, contact diode laser TSCPC is an effective and safe technique for IOP reduction in this experiment. Therefore, the laser application number can increase to more than 12 shots to enhence its effect. However, optimal protocol for treatment have not yet been firmly established. A longer follow-up is required to confirm this conclusion.