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微脉冲与缓慢凝固 透膜环光凝固在耐火性玻璃眼中:一项随机临床试验
César R de Lima Neto1, Gabriel Ayub1, Samuel Goulart N E Silva1
1Department of Ophthalmology - University of Campinas, Campinas, Brazil.
Ophthalmology. Glaucoma
|December 10, 2025
概括
微脉冲横环光凝血 (MP-TSCPC) 和缓慢凝血横环光凝血 (SC-TSCPC) 均可降低耐火性玻璃眼的眼内压力 (IOP). SC-TSCPC提供更大的IOP降低,但携带更高的并发症风险.
科学领域:
- 眼科医生 眼科 眼科
- 青光眼治疗方法 青光眼治疗方法
- 手术创新 在外科创新.
背景情况:
- 耐火性玻璃眼对维护视觉功能构成重大挑战.
- 透细胞循环光凝固 (TSCPC) 是一种已被确立的晚期青光眼的治疗方法.
- 对比不同的TSCPC模式对于优化患者的治疗结果至关重要.
研究的目的:
- 为了比较微脉冲跨细胞循环光凝 (MP-TSCPC) 与缓慢凝血跨细胞循环光凝 (SC-TSCPC) 的疗效和安全性.
- 为了评估耐火性玻璃眼患者在12个月的随访期间的结果.
主要方法:
- 进行了一项并行,双臂,单中心,双面罩,随机的临床试验.
- 80名耐火性玻璃眼患者的80只眼睛被随机 (1:1) 分给MP-TSCPC或SC-TSCPC.
- 主要结局:平均眼内压 (IOP) 降低;次要结局:药物使用,成功率和并发症.
主要成果:
- 无论是MP-TSCPC还是SC-TSCPC,都显著降低了12个月后的IOP (p < 0.001).
- 与MP-TSCPC (52%) (p=0.03) 相比,SC-TSCPC显示了更大的平均内血压减少 (61%).
- 与MP-TSCPC (35.1%) 相比,SC-TSCPC的并发症发生率更高 (58.9%),包括低血压.
结论:
- 两种MP-TSCPC和SC-TSCPC都有效地降低了耐火性玻璃眼的IOP.
- SC-TSCPC提供了优异的IOP降低,但与术后并发症的增加有关.
- 术前内血压>30mmHg或早期术后内血压>15mmHg是手术失败的预测因素.
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