角度閉塞の予防のためのレーザー外周性アイリドトミー:単一センター,ランダム化制御試験

Mingguang He¹, Yuzhen Jiang², Shengsong Huang³

¹State Key Laboratory of Ophthalmology, Clinical Research Center, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China; Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia; National Institute for Health Research Biomedical Research Centre, Moorfields Eye Hospital, London, UK; UCL Institute of Ophthalmology, London, UK.

Lancet (London, England)

|March 18, 2019

まとめ

レーザー外側アイリドトミー (LPI) は,中国人の疑いのある患者に主角閉塞病に対する控えめな予防効果を示した. しかし,病気の発生率が低いため,広範なLPIは推奨されません.

科学分野:

眼科について
公衆衛生

背景:

プライマリ・クローズド・アングル・グラウコマ (PACG) は,世界中で何百万もの患者に影響し,プライマリ・クローズド・アングル・クローズド・アングル・グラウコマ (PACS) の患者はリスクが高い.
予防戦略では,PACSがPACGを発症するリスクを定量化することが重要です.

研究の目的:

中国のPACSにおけるPACGの予防療法として,レーザー周辺性皮膜切除 (LPI) の有効性と安全性を評価する.
事故を防ぐためにLPIの長期的な成果を評価する.

主な方法:

中国広州の 50- 70 歳の両方の PACS に関するランダム制御試験.
参加者はランダムに選択された1つの目でLPIを投与され,他の目は未治療の対照として使用されました.
主な評価項目は,72ヶ月間にわたる眼内圧上昇,外側前部シネキア,または急性角閉塞の発生率でした.

主要な成果:

PACGの発生率は,LPI治療を受けた眼 (1000眼年あたり4. 19) で,未治療眼 (1000眼年あたり7. 97) と比較して,著しく低かった (HR0. 53,p=0. 024).
治療対象の眼は19本,未治療の眼は36本 (p=0. 0041) であった.
フォローアップ期間中に重大な有害事象は報告されなかった.

結論:

コミュニティで検診された中国のPACSでは,PACGの発生率が低い.
LPIは,PACGに対する統計的に有意な,しかし控えめな予防効果を示した.
発症率が低く,視界の脅威が限られているため,PACSに対する日常的な予防LPIは推奨されません.

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