METHODS: This prospective interventional study included patients with refractory glaucoma who underwent TSCPC with trans-corneal transillumination (TSCPC-TI) using a novel low-cost torchlight method. Patients completing a minimum 6-month follow-up were analyzed. They were compared to a historical control group of patients who underwent TSCPC without transillumination (TSCPC-No TI) at 6-month follow-up period. We analyzed the mean laser energy delivered, post-laser intraocular pressure (IOP) reduction, number of antiglaucoma medications (AGM), the requirement of retreatment and complications of the procedure in both groups.
RESULTS: 32 eyes of 29 patients comprised the TSCPC-TI group and were compared with 39 eyes of 37 patients in the TSCPC-No TI group. The TSCPC-TI group required lower energy than the TSCPC-No TI group (46.15 ± 22.8 Vs 80.65 ± 56.1 J p < 0.001). At 6-month follow-up, the TSCPC-TI group required lesser AGM for IOP control (2.33 ± 1.02 vs 3.02 ± 1.32 p = 0.01). There was a significantly reduced dependence of oral acetazolamide in the TSCPC-TI group at 6 months follow-up (15.6% vs 41% p = 0.03%). The success and response rates were 71.8% Vs 23.1%; p < 0.0001 and 87.5% Vs 51.2%; p = 0.001 significantly high in the TSCPC-TI group. The TSCPC-No TI group had a significantly high failure rate (12.5% Vs 48.2% p = 0.001). Hypotony (n = 1) and phthisis (n = 2) were noted TSCPC-No TI group.
CONCLUSIONS: TSCPC with transillumination with a low-cost torchlight resulted in a more efficient and effective cycloablation than TSCPC without transillumination.
方法:这项前瞻性介入研究包括难治性青光眼患者,这些患者使用一种新型的低成本火炬照法进行TSCPC和跨角膜透照(TSCPC-TI)。分析完成至少6个月随访的患者。将它们与在6个月随访期间接受TSCPC而没有透照(TSCPC-NoTI)的患者的历史对照组进行比较。我们分析了传递的平均激光能量,激光后眼内压(IOP)降低,抗青光眼药物(AGM)的数量,两组的再治疗需求和手术并发症。
结果:TSCPC-TI组29例患者的32只眼,与TSCPC-NoTI组37例患者的39只眼进行比较。TSCPC-TI组需要的能量低于TSCPC-NoTI组(46.15±22.8vs80.65±56.1Jp<0.001)。在6个月的随访中,TSCPC-TI组需要较少的AGM来控制IOP(2.33±1.02vs3.02±1.32p=0.01)。在6个月的随访中,TSCPC-TI组的口服乙酰唑胺依赖性显着降低(15.6%vs41%p=0.03%)。TSCPC-TI组的成功率和有效率分别为71.8%vs23.1%;p<0.0001和87.5%vs51.2%;p=0.001,明显较高。TSCPC-NoTI组的失败率明显较高(12.5%vs48.2%p=0.001)。TSCPC-NoTI组注意到低张力(n=1)和Phthisis(n=2)。
结论:TSCPC与低成本火炬照明相比,具有更有效和更有效的循环消融。