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要約 目的:選択的レーザー線維柱帯形成術の結果の報告。症例と方法:緑内障の28例35眼を対象とした。男性16例,女性12例で,年齢は平均66.9±13.8歳であり,18眼が有水晶体,17眼が偽水晶体眼であった。病型は原発開放隅角緑内障26眼,正常眼圧緑内障6眼,落屑緑内障3眼で,3か月以上,平均8.8か月の経過を追った。Nd:YAGレーザーの照射部位は下方半周とし,70~90発の照射をした。結果:平均眼圧は,術前21.1±5.3mmHg,術後3か月16.1±4.7mmHg,術後6か月15.1±3.6mmHgであった。眼圧下降率は19眼(54%)が20%以上,16眼(46%)が20%未満であった。未満群のうち6眼(17%)に再照射を行い,3眼(9%)に線維柱帯切除術を行った。術前に2剤以下の点眼をしている症例は,それ以上の症例よりも有効であった(p<0.05)。結論:選択的レーザー線維柱帯形成術は,安全で眼圧下降効果がある。高眼圧の緑内障では,観血的手術の前に考慮してよい治療である。
Abstract. Purpose:To report the outcome of selective laser trabeculoplasty. Cases and Method:This retrospective study was made on 35 eyes of 28 patients. The series comprised 16 males and 12 females. The age averaged 66.9±13.8 years. Eighteen eyes were phakic and 17 were pseudophakic. Primary open-angle glaucoma was present in 26 eyes, normal-tension glaucoma in 6 eyes, and capsular glaucoma in 3 eyes. Cases were followed up for 3 months or longer, average 8.8 months. Nd:YAG laser was applied to inferior sector totaling 70 to 90 shots. Results:Intraocular pressure(IOP)averaged 21.1±5.3 mmHg before treatment, 16.0±4.7 mmHg after 3 months, and 16.9±4.4 mmHg after 6 months. IOP decreased by 20% or more in 19 eyes(54%)and less in 16 eyes(46%). Out of these 16 eyes, 6 eyes(17%)received the same treatment and 3 eyes(9%)received laser trabeculectomy. Eyes receiving 2 or less topical medications showed significantly greater reduction in IOP than the rest(p<0.05). Conclusion:Selective laser trabeculoplasty is safe and effective in reducing IOP. This therapeutic modality is indicated for glaucoma with elevated IOP.
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