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題名 | 接觸式二極體雷射經鞏膜睫狀體光凝固術在青光眼的初步經驗=Initial Experience of Contact Diode Laser Transscleral Cyclophotocoagulation in Glaucoma Patients |
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作者 | 吳明哲; 李英麒; 洪伯廷; 王清泓; | 書刊名 | 中華民國眼科醫學會雜誌 |
卷期 | 35:1 1996.03[民85.03] |
頁次 | 頁1-7 |
分類號 | 416.748 |
關鍵詞 | 接觸式二極體雷射經鞏膜睫狀體光凝固術; 青光眼; 睫狀體破壞手術; Cyclodestructive surgery; Diode laser; G-probe; Transscleral cyclophotocoagulation; |
語文 | 中文(Chinese) |
中文摘要 | 最近國外使用接觸式二極體雷射經鞏膜睫狀體光凝固術治療難癒性青 光眼顯示良好的療效。本報告為以較低總能量初步對國人之使用報告。本研究應 用G-Probe對18例20眼難癒性青光眼實施接觸式二極體雷射經鞏膜睫狀體光凝固 術治療的結果。瞄準部位距輪部1.0到1.2mm之結膜部,每一眼接受的燒灼點數為 9到12點,範圍為270°。雷射光波長810mm,使用功率1.5到2watt,燒灼時間為2 秒。術後追蹤1到6個月,術後1個月眼壓較術前下降12.2±12.6mmHg(P=0.002),術 後3及6個月眼壓下降已不具統計上的意義。術後1、3及6個月眼壓較術前降低20 或超過20的比率分別為61、45及11。術後並無明顯的併發症。我們刻意減少燒灼 點數為9到12點,有別於國外的16到18點,治療時的起始功率從1.5watt開始,也較 國外為低,結果僅在術後1個月呈現有意義的降壓效果。本篇雖為初步研究結果, 仍顯示接觸式二極體雷射經鞏膜睫狀體光凝固術在青光眼的治療上有其價值。由 經驗顯示,初步低能量之照射對國人並無特別明顯的副作用,欲維持更長久之降 壓效果,將來應考慮增加燒灼點以及功率,而長期的效果及併發症也需要更長期 的觀察才能了解。 |
英文摘要 | Purpose: Recently, an effective contact diodelaser system with less complication for transscleralcyclophotocoagulation (TSCPC) has been developedfor refractory glaucoma. Our report will introduceour experience on this new procedure. Methods: Wetreated glaucoma patients refractory to medical, laserand surgical therapies with the IRIS Medical OculightSLx Diode Laser System and the IRIS G-Probe. Eacheye received 9 to 12 laser applications evenly spacedover 270± centered 1.0 to 1.2 mm behind the surgicallimbus. We selected powers of 1.5,1.75,2 watts andused a duration of 2.0 seconds. Results were analyzedusing paired t-test. Results: Total 20 eyses of 18patients (12 males, 6 females, age 47.4 ± 20.4 years old) were treated. The length of follow-up in thisstudy ranged from I month to 6 months. IOP reduction was statistically significant within I month.No major complication and in particular, no conjunctival lesions were found. Conclusions: According to the initial experience, contact diode laserTSCPC is an effective and safe technique for IOPreduction in this experiment. Therefore, the laserapplication number can increase to more than 12 shotsto enhence its effect. However, optimal protocol fortreatment have not yet been firmly established. Alonger follow-up is required to confirm thisconclusion. |
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