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用激光进行外周虹膜切除,以防止角关闭:单中心随机对照试验

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.

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|March 18, 2019
PubMed
概括

激光外周 iridotomy (LPI) 在中国的疑似患者中显示出适度的预防性作用. 然而,由于疾病发病率低,不建议广泛使用LPI.

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科学领域:

  • 眼科 眼科
  • 公共卫生

背景情况:

  • 全球有数以百万计的患者患有原发性角闭眼镜 (PACG),而原发性角闭眼镜 (PACS) 患者的风险较高.
  • 量化PACS发展PACG的风险对于预防策略至关重要.

研究的目的:

  • 评估激光外周 iridotomy (LPI) 的疗效和安全性,作为预防性治疗中国PACS.
  • 评估LPI的长期结果,以防止发生PACG事故.

主要方法:

  • 一项随机对照试验,涉及50至70岁的双边PACS在中国广州.
  • 参与者在一个随机选择的眼睛中接受LPI,另一只眼睛作为未经治疗的对照.
  • 主要结论是72个月的PACG发病率,定义为眼内压力升高,外周前侧或急性角关闭.

主要成果:

  • 与未经治疗的眼睛 (7. 97) 相比,用LPI治疗的眼睛中PACG的发生率明显较低 (HR为0. 53,p=0. 024).
  • 在19个接受治疗的眼睛和36个未接受治疗的眼睛中发生了主要结果事件 (p=0. 0041).
  • 在随访期间没有报告严重不良事件.

结论:

  • 在社区查的中国PACS中,PACG的发病率很低.
  • 在LPI中显示出对PACG具有统计学意义但适度的预防作用.
  • 鉴于发病率低且对结果的视觉威胁有限,不建议对PACS进行常规预防LPI.