Abstract：
OBJECTIVE: This study aimed to compare the safety and effectiveness of intraocular pressure reduction between micropulse transscleral cyclophotocoagulation and \"slow cook\" transscleral cyclophotocoagulation in patients with refractory primary open-angle glaucoma.
METHODS: We included patients with primary open angle glaucoma with at least 12 months of follow-up. We collected and analyzed data on the preoperative characteristics and postoperative outcomes. The primary outcomes were a reduction of ≥20% of the baseline value (criterion A) and/or intraocular pressure between 6 and 21 mmHg (criterion B).
RESULTS: We included 128 eyes with primary open-angle glaucoma. The preoperative mean intraocular pressure was 25.53 ± 6.40 and 35.02 ± 12.57 mmHg in the micropulse- and \"slow cook\" transscleral cyclophotocoagulation groups, respectively (p<0.001). The mean intraocular pressure was reduced significantly to 14.33 ± 3.40 and 15.37 ± 5.85 mmHg in the micropulse- and \"slow cook\" transscleral cyclophotocoagulation groups at the last follow-up, respectively (p=0.110). The mean intraocular pressure reduction at 12 months was 11.20 ± 11.46 and 19.65 ± 13.22 mmHg in the micropulse- and \"slow cook\" transscleral cyclophotocoagulation groups, respectively (p<0.001). The median preoperative logMAR visual acuity was 0.52 ± 0.69 and 1.75 ± 1.04 in the micropulse- and \"slow cook\" transscleral cyclophotocoagulation groups, respectively (p<0.001). The mean visual acuity variation was -0.10 ± 0.35 and -0.074 ± 0.16 in the micropulse- and \"slow cook\" transscleral cyclophotocoagulation, respectively (p=0.510). Preoperatively, the mean eye drops were 3.44 ± 1.38 and 2.89 ± 0.68 drugs in the micropulse- and \"slow cook\" transscleral cyclophotocoagulation groups, respectively (p=0.017), but those were 2.06 ± 1.42 and 1.02 ± 1.46 at the end of the study in the \"slow cook\" and micropulse transscleral cyclophotocoagulation groups, respectively (p<0.001). The success of criterion A was not significant between both groups. Compared with 11 eyes (17.74%) in the \"slow cook\" transscleral cyclophotocoagulation group, 19 eyes (28.78%) in the micropulse transscleral cyclophotocoagulation group showed complete success (p=0.171). For criterion B, 28 (42.42%) and 2 eyes (3.22%) showed complete success after micropulse- and \"slow cook\" transscleral cyclophotocoagulation, respectively (p<0.001).
CONCLUSIONS: Both techniques reduced intraocular pressure effectively.
METHODS: We included patients with primary open angle glaucoma with at least 12 months of follow-up. We collected and analyzed data on the preoperative characteristics and postoperative outcomes. The primary outcomes were a reduction of ≥20% of the baseline value (criterion A) and/or intraocular pressure between 6 and 21 mmHg (criterion B).
RESULTS: We included 128 eyes with primary open-angle glaucoma. The preoperative mean intraocular pressure was 25.53 ± 6.40 and 35.02 ± 12.57 mmHg in the micropulse- and \"slow cook\" transscleral cyclophotocoagulation groups, respectively (p<0.001). The mean intraocular pressure was reduced significantly to 14.33 ± 3.40 and 15.37 ± 5.85 mmHg in the micropulse- and \"slow cook\" transscleral cyclophotocoagulation groups at the last follow-up, respectively (p=0.110). The mean intraocular pressure reduction at 12 months was 11.20 ± 11.46 and 19.65 ± 13.22 mmHg in the micropulse- and \"slow cook\" transscleral cyclophotocoagulation groups, respectively (p<0.001). The median preoperative logMAR visual acuity was 0.52 ± 0.69 and 1.75 ± 1.04 in the micropulse- and \"slow cook\" transscleral cyclophotocoagulation groups, respectively (p<0.001). The mean visual acuity variation was -0.10 ± 0.35 and -0.074 ± 0.16 in the micropulse- and \"slow cook\" transscleral cyclophotocoagulation, respectively (p=0.510). Preoperatively, the mean eye drops were 3.44 ± 1.38 and 2.89 ± 0.68 drugs in the micropulse- and \"slow cook\" transscleral cyclophotocoagulation groups, respectively (p=0.017), but those were 2.06 ± 1.42 and 1.02 ± 1.46 at the end of the study in the \"slow cook\" and micropulse transscleral cyclophotocoagulation groups, respectively (p<0.001). The success of criterion A was not significant between both groups. Compared with 11 eyes (17.74%) in the \"slow cook\" transscleral cyclophotocoagulation group, 19 eyes (28.78%) in the micropulse transscleral cyclophotocoagulation group showed complete success (p=0.171). For criterion B, 28 (42.42%) and 2 eyes (3.22%) showed complete success after micropulse- and \"slow cook\" transscleral cyclophotocoagulation, respectively (p<0.001).
CONCLUSIONS: Both techniques reduced intraocular pressure effectively.
摘要：
目的：本研究旨在比较微脉冲经巩膜睫状体光凝术和“缓慢煮”经巩膜睫状体光凝术在难治性原发性开角型青光眼患者中降低眼压的安全性和有效性。
方法：我们纳入了至少12个月随访的原发性开角型青光眼患者。我们收集并分析了有关术前特征和术后结局的数据。主要结果是基线值降低≥20%（标准A）和/或眼压在6和21mmHg之间（标准B）。
结果：我们纳入了128眼原发性开角型青光眼。经巩膜睫状体光凝组术前平均眼压分别为25.53±6.40和35.02±12.57mmHg,分别(p<0.001)。末次随访时经巩膜睫状体微脉和"慢煮"组平均眼压显著降低至14.33±3.40和15.37±5.85mmHg,分别(p=0.110)。经巩膜睫状体光凝组12个月时平均眼压下降11.20±11.46和19.65±13.22mmHg,分别(p<0.001)。经巩膜睫状体光凝组的术前logMAR视力中位数分别为0.52±0.69和1.75±1.04,分别(p<0.001)。经巩膜睫状体光凝术的平均视力变化为-0.10±0.35和-0.074±0.16，分别(p=0.510)。术前,经巩膜睫状体光凝组的平均滴眼液为3.44±1.38和2.89±0.68药物，分别(p=0.017)，但在研究结束时，“慢煮”和微脉冲经巩膜睫状体光凝组分别为2.06±1.42和1.02±1.46，分别(p<0.001)。标准A的成功在两组之间并不显著。与“慢煮”经巩膜睫状体光凝组的11只眼(17.74%)相比，微脉冲经巩膜睫状体光凝组19只眼(28.78%)完全成功(p=0.171)。对于标准B，28只(42.42%)和2只眼(3.22%)在微髓和“慢煮”经巩膜睫状体光凝后显示完全成功，分别(p<0.001)。
结论：两种技术均能有效降低眼压。
方法：我们纳入了至少12个月随访的原发性开角型青光眼患者。我们收集并分析了有关术前特征和术后结局的数据。主要结果是基线值降低≥20%（标准A）和/或眼压在6和21mmHg之间（标准B）。
结果：我们纳入了128眼原发性开角型青光眼。经巩膜睫状体光凝组术前平均眼压分别为25.53±6.40和35.02±12.57mmHg,分别(p<0.001)。末次随访时经巩膜睫状体微脉和"慢煮"组平均眼压显著降低至14.33±3.40和15.37±5.85mmHg,分别(p=0.110)。经巩膜睫状体光凝组12个月时平均眼压下降11.20±11.46和19.65±13.22mmHg,分别(p<0.001)。经巩膜睫状体光凝组的术前logMAR视力中位数分别为0.52±0.69和1.75±1.04,分别(p<0.001)。经巩膜睫状体光凝术的平均视力变化为-0.10±0.35和-0.074±0.16，分别(p=0.510)。术前,经巩膜睫状体光凝组的平均滴眼液为3.44±1.38和2.89±0.68药物，分别(p=0.017)，但在研究结束时，“慢煮”和微脉冲经巩膜睫状体光凝组分别为2.06±1.42和1.02±1.46，分别(p<0.001)。标准A的成功在两组之间并不显著。与“慢煮”经巩膜睫状体光凝组的11只眼(17.74%)相比，微脉冲经巩膜睫状体光凝组19只眼(28.78%)完全成功(p=0.171)。对于标准B，28只(42.42%)和2只眼(3.22%)在微髓和“慢煮”经巩膜睫状体光凝后显示完全成功，分别(p<0.001)。
结论：两种技术均能有效降低眼压。
