激光小梁成形术--氩激光还是二极管激光?

Anne MV Brooks, WE Gillies
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摘要

比较最近推出的二极管激光与目前用于小梁成形术的氩激光的降压效果非常重要,因为两者的波长有很大差异。氩激光小梁成形术(ALT)使 50 名患者的眼压在三个月后从 23 mmHg 降至 18 mmHg,而二极管激光小梁成形术(DLT)使眼压在三个月后从 23 mmHg 降至 19 mmHg。这一差异没有统计学意义。比较两组 50 只眼睛的眼压(IOP)下降幅度,28 名患者的 ALT 眼压(IOP)下降了 5 mmHg 或更多,17 名患者的 DLT 眼压(IOP)下降了 5 mmHg 或更多,差异显著(χ2 1df=4.04, P<0.05)。将 23 只均需进行激光小梁成形术的配对眼进行比较,接受 ALT 治疗的眼压从 22 mmHg 降至 17 mmHg,而接受 DLT 治疗的眼压从 22 mmHg 降至 19 mmHg,这一差异具有统计学意义(T = 53.5,P<0.02,Wilcoxon 匹配配对符号秩检验)。这些结果表明,DLT 的降压效果与 ALT 不相上下,但 ALT 的降压效果更好,因为在同一患者的双眼中,ALT 后眼压的下降幅度大于 DLT。在非配对眼中,ALT 的降压幅度达到或超过 5 mmHg 的次数明显多于 DLT,尽管两组的平均降压幅度没有统计学差异。
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Laser trabeculoplasty — argon or diode?*
It is important to compare the pressure‐lowering effect of the recently introduced diode laser with that of the argon laser currently used for trabeculoplasty, since there is a considerable difference in their wavelengths. In 50 consecutive eyes of 50 patients argon laser trabeculoplasty (ALT) produced a fall from 23 to 18 mmHg at three months compared with a fall from 23 to 19 mmHg at three months with diode laser trabeculoplasty (DLT). This difference was not statistically significant. Comparing the magnitude of the fall in intraocular pressure (IOP) in these two groups of 50 eyes, 28 patients achieved a fall of 5 mmHg or more with ALT and 17 with DLT and this difference was significant (χ2 1df=4.04, P<0.05). Comparing 23 paired fellow eyes which both needed laser trabeculoplasty, those treated with ALT achieved a fall from 22 to 17 mmHg compared with a fall from 22 to 19 mmHg with DLT and this difference was statistically significant (T = 53.5, P<0.02, Wilcoxon matched‐pairs signed rank test). These results suggest that the pressure lowering effect of DLT is comparable to that of ALT, but ALT is somewhat more effective as shown by a greater fall in IOP after ALT than DLT in fellow eyes of the same patient. In the unpaired eyes the number of falls of 5 mmHg or more was significantly greater with ALT than DLT, although the mean fall was not statistically different between the two groups.
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